Professional Documents
Culture Documents
Question Bank
Question Bank
FM-1.7.
The use of which of the following should be avoided in patients
receiving monoamino-oxidase inhibitor therapy:
A) cheese
B) imipramine (Melipramin)
C) phentolamine (Regitin)
D) pethidine (Dolargan)
E) sulphonamides
FM-1.8.
Which of the following conditions are usually associated with purpura?
A) Henoch-Schonlein syndrome
B) hepatic cirrhosis
C) systemic lupus erythematosus
D) Addison's disease
E) Raynaud's phenomenon
FM-1.9.
Bone density is markedly increased in:
A) osteopetrosis
B) Paget's disease of the bone
C) following the intake of a large amount of fluoride
D) hyperparathyroidism
E) renal osteodystrophy
FM-1.10
Which of the following conditions is associated with a male-type
distribution of hair in females?
A) myxedema
B) true hermaphroditism
C) Laurence-Moon-Biedl syndrome
D) Stein-Leventhal.syndrome (polycystic ovary)
E) Cushing's syndrome
FM-1.11.
In which of the following conditions can central cyanosis be detected?
A) methemoglobinemia
B) ventilation-perfusion mismatch
C) pulmonary arteriovenous fistula
D) heatstroke
E) heavy physical exercise
FM-1.12.
Which of- the following statements about delirium tremens are correct?
A) chlormethiazole (Heminevrin) is suitable for treatment
B) acoustic hallucinations are common
C) visual hallucinations are common
D) elecroshock therapy is indicated in severe cases
E) the condition may be fatal
FM-1.13.
In which of the following conditions can renal failure be fatal?
A) hypernephroma
B) systemic lupus erythematosus (SLE)
C) Weil's disease
D) renal tuberculosis
E) accelerated hypertension
FM-1.14.
Penicillin administration is the appropriate therapy in which of the
following complications of syphilis?
A) meningitis
B) aneurysm of the aorta
C) interstitial keratitis
D) condyloma latum
E) the generalized paralysis of psychotic patients
FM-1.15.
Characteristics of mycoplasma-pneumonia include:
A) pleural effusion as a common complication
B) the presence of cold agglutinins
C) associated renal failure
D) a good response to tetracyclines
E) patients immunized against mycoplasma are resistant
FM-1.16.
Which of the following statements about post-traumatic epilepsy are
correct?
A) it usually follows head trauma within a month
B) the CT reveals the causative abnormalities
C) it requires surgical therapy in most cases
D) it responds poorly to standard anticonvulsive therapy
E) the EEG reveals its characteristic changes
FM-1.17.
Macroglossia is a possible feature of which of the following conditions?
A) acromegaly
B) Marfan's syndrome
C) Hurler's syndrome
D) achondroplasia
E) amyloidosis
FM-1.18.
A paradoxically split second heart sound is a feature of.,
A) severe pulmonary stenosis
B) a ventricular septal defect
C) severe aortic stenosis
D) a patent ductus arteriosus
E) complete right bundle branch block
FM-1.19.
Bilateral parotid gland enlargement is a symptom of
A) Mikulicz's syndrome
B) infectious mononucleosis
C) mumps
D) brucellosis
E) sarcoidosis
FM-1.20.
Which of the following statements about Conn's syndrome are correct?
A) a high aldosterone level in the serum is a characteristic finding
FM-1.27.
Which of the following conditions is associated with true hematuria?
A) urinary tract tuberculosis
B) acute pyelonephritis
C) acute cystitis
D) malignant hypertension
E) renal infarction
FM-1.28.
Which of the following statements about medullary cystic kidney
disease are correct?
A) the prognosis is usually poor
B) it is usually manifested during childhood
C) the diagnosis is based on the associated radiological findings
D) renal calculi may be present
E) renal function is frequently impaired
FM-1.29.
In the carcinoid syndrome:
A) mitral stenosis is a possible complication
B) it may be diagnosed by measuring the vanillylmandelic acid
(VMA) concentration in the urine
C) the application of methysergide (Deseril) is a possible therapeutic
intervention
D) any associated alcohol intake can induce a facial blushing
E) chronic dyspnea is a recognized complication
FM-1.30.
Primary optic nerve atrophy is a recognized complication of:
A) glaucoma
B) disseminated sclerosis
C) Paget's disease of the skull
D) neurosyphilis
E) ethambutol (Sural) therapy
FM-1.31.
Recognized causes of motor neuropathy include:
A) diabetes mellitus
B) porphyria
C) Guillain-Barre syndrome
D) Friedrich's ataxia
E) diphtheria
FM-1.32.
Possible causes of hypercholesterolemia include:
A) primary biliary cirrhosis
B) the nephrotic syndrome
C) hyperthyroidism
D) hepatocellular jaundice
E) Gaucher's disease
FM-1.33.
Which of the following statements about Charcot's joint are correct?
A) it is caused by syringomyelia
B) it is caused by diabetes mellitus
FM-1.40.
Which of the following conditions are related to psychosomatic disorders?
A) systemic lupus erythematosus
B) vasomotor rhinitis
C) peptic ulcer
D) diabetes mellitus
E) Bartter's syndrome
FM-1.41.
Which of the following compounds are well known antidotes?
A) naloxone - morphine overdose
B) pralidoxime - parathione intoxication
C) dimercaptol - cyanide intoxication
D) orphenadrine - pyridostigmine intoxication
E) cobalt-EDTA - haloperidol overdose
FM-1.42.
HLA B8-linked diseases include:
A) multiple sclerosis
B) dermatitis herpetiformis
C) celiac disease
D) ankylosing spondylitis
E) myasthenia gravis
FM-1.43.
Factors stimulating gastrin secretion include:
A) gastric wall distension
B) acid in the lumen of the stomach
C) glucagon
D) calcium
E) secretin
FM-1.44.
Hyperparathyroidism is associated with:
A) hypocalcemia
B) psychosis
C) constipation
D) Trousseau's sign
E) renal stones with the risk of urinary obstruction
FM-1.45.
Brucellosis is usually associated with:
A) bilateral hilar lymphadenopathy which can be observed on the
chest x-ray
B) jaundice
C) spontaneous remissions of several weeks to months in length
D) splenomegaly
E) marked sweating
FM-1.46.
Which of the following statements about anthrax are correct?
A) it is an occupational disease
B) Woolsorter's disease develops following the inhalation of the
causative microorganism
C) more than 90% of patients exhibit skin lesions
FM-1.53.
Neuropsychiatric symptoms of hepatic insufficiency include:
A) a reverse sleep pattern
B) Argyll-Robertson pupils
C) myelopathy with paraplegia
D) perseveration signs
E) diagnostic EEG abnormalities
FM-1.54. Which of the following statements about psoriatic arthropathy are correct?
A) it affects 20% of psoriatic patients
B) all joints are symmetrically affected
C) sacroileitis is a characteristic finding
D) the joints of the hand frequently exhibit minimal destructive
abnormalities
E) the application of steroids is usually contraindicated
FM-1.55.
Which of the following statements about gastric secretion are correct?
A) approximately 250 ml gastric juice is secreted daily
B) gelatinase is a normal constituent of gastric juice
C) the stomach is capable of producing both acidic or alkaline
secretions
D) if the rate of production is slow, the Na+ concentration is high
E) only the glands of the pyloric region are capable of secreting
mucus
FM-1.56.
Characteristics of mediastinal emphysema include:
A) marked suprasternal pulsation
B) Hamman's sign (a crackling sound synchronous with cardiac
systole)
C) pain in the throat
D) gas under the diaphragm
E) cyanosis
FM-1.57.
Transient amnesia is possible:
A) following head trauma
B) in patients suffering from epilepsy
C) in cerebrovascular insufficiency
D) in Alzheimer's disease
E) in patients with a temporal lobe tumor
FM-1.58.
Paresthesia associated with pruritus is characteristic for which of
the following conditions?
A) multiple sclerosis
B) temporal lobe epilepsy
C) Raynaud's phenomenon
D) acromegaly
E) hypoventilation
FM-1.59.
An abnormality of speech is a recognized complication of.
A) dementia paralitica (a generalized paralysis of the psychotic
patient)
B) congenital diplegia
C) Friedrich's ataxia
D) amyotrophic lateral sclerosis
E) severe glossitis
FM-1.60.
In which of the following conditions does palpation reveal uneven,
rough liver edges?
A) alcoholic cirrhosis after the withdrawal of alcohol
B) secondary syphilis
C) hepatic actinomycosis
D) Wilson's disease
E) an amebic hepatic abscess
FM-1.61.
In polycythemia rubra vera:
A) the reticulocyte count is typically elevated
B) the leukocyte alkaline phosphatase activity is low
C) 30% of patients exhibit hyperuricosuria
D) the vitamin B12 binding capacity in the serum is elevated
E) the serum total iron level is typically elevated
FM-1.62.
Which of the following statements about methemoglobinemia are correct?
A) it is caused by a cytochrome B5 reductase deficiency
B) the color of the blood is chocolate brown
C) the family history is usually positive
D) if treatment is indicated, the intravenous administration of
methylene blue is a possible intervention
E) cyanosis is a characteristic finding
FM-1.63.
In eczema of infancy:
A) eruptions are characteristically present at birth
B) the papules cause itching
C) cold weather relieves the symptoms
D) in 70% of cases the family history reveals data indicative of the
disease
E) the presence of dermographism excludes the diagnosis
FM-1.64.
Which of the following statements about Letterer-Siwe disease are correct?
A) this is a slowly progressing disease of childhood
B) a generalized lymphadenopathy is characteristic
C) severe hemorrhagic eruptions occur
D) the reaction to corticosteroids is usually positive
E) a "honeycomb lung" on the x-ray film is of diagnostic value
FM-1.65
Tetralogy of Fallot:
A) pulmonary stenosis in most cases is due to an obstruction of
the valve
B) cyanosis might be absent in the first few months of life
C) can be associated with convulsions
D) the second pulmonary sound becomes widely split
E) the pulmonary fields are typically flooded on the chest x-ray
FM-1.66.
Recognized causes of a childhood onset hepatic cirrhosis include:
A) Gaucher's disease
B) occlusive disease of the hepatic vein
C) xanthomatosis
D) alcoholism during pregnancy
E) celiac disease
FM-1.67.
A 12-week-old healthy infant:
A) would react if called by his/her name
B) turns his/her head towards a summoning voice
C) produces a grabbing reflex in response to the proper stimulus
D) can recognize the feeding bottle
E) can elevate his/her head from the pillow
FM-1.68.
Characteristics of Korsakoffs syndrome include:
A) polyneuritis which is detected in all cases
B) a clear consciousness
C) impaired judgement
D) morphological abnormalities in the hypothalamus
E) confabulation
FM-1.69.
Symptoms suggestive of childhood onset schizophrenia include:
A) abnormal movements
B) persistent sucking of the finger
C) resistance against changes in the environment
D) infantile autism
E) negativism
FM-1.70.
Signs indicative of a good prognosis in schizophrenia include:
A) an acute onset of the disease
B) a positive family history
C) a previously stable personality
D) a pycnic constitution
E) an early onset of the disease
FM-1.71.
Haloperidol:
A) is effective in the treatment of depressive psychosis
B) has a marked antiemetic effect
C) has marked extrapyramidal side effects
D) is administered only in the form of an injection
E) can be used to substitute for phenothiazine derivatives in
patients who become jaundiced following phenothiazine administration
FM-1.72.
Indications of penicillamine therapy include:
A) systemic sclerosis
B) primary biliary cirrhosis
C) recurrent polychondritis
D) hemosiderosis
D) pericarditis
E) strong lumbar pain
FM-1.80.
In Paget's disease of the bone (osteitis deformans)
A) the serum alkaline phosphatase activity is normal unless the
patient has had a recent fracture
B) the serum phosphate concentration is typically low
C) there is a high risk of renal stone formation
D) adequate therapy includes the administration of a high dose of
steroids
E) there is a periosteal thickening
FM-1.81.
In Hodgkin's disease:
A) a delayed type hypersensitivity reaction is abnormal
B) the diagnosis can be made with a bone marrow smear in 50% of cases
C) eosinophilia is detected in approximately 10% of cases
D) absolute lymphocytosis is a typical finding
E) hemolytic anemia may occur
FM-1.82.
Complications of massive irradiation include:
A) an increased prevalence of leukemia
B) a thrombocytopenia developing within 4 days
C) an increased prevalence of visceral malignancies
D) leukemoid reactions in some patients.
E) hemolytic anemia
FM-1.83.
Which of the following statements relating to transplantation immunology
are correct?
A) a hyperacute rejection is mediated by T-lymphocytes
B) an early acute rejection is mediated by B-lymphocytes
C) a chronic rejection is mediated by immunoglobulins
D) prophylactic steroid therapy effectively reverses any rejection
of the transplanted organ
E) antilymphocyte globulin is effective in the destruction of small
lymphocytes
FM-1.84. Osteoporosis:
A) causes an elevation of the serum calcium concentration
B) typically causes elevation of the alkaline phosphatase activity
C) causes pain in the bones
D) improves during bed rest
E) the response to calcium substitution therapy is usually positive
FM-1.85. Mydriasis is a recognized complication of.
A) a paralysis of the oculomotor nerve
B) Horner's syndrome
C) retrobulbar neuritis
D) iritis
E) Adie's pupil syndrome
FM-1.86.
Which of the following statements about rubella during pregnancy are
correct?
A) in the first trimester, it is usually associated with a higher risk
of fetal developmental abnormalities
B) it causes cardiac anomalies in the newborn
C) it causes deafness in the newborn
D) retinopathy is a well known complication
E) the virus is easily isolated from the throat of the newborn even
if there is no other evidence for the disease
FM-1.87
Alpha, -antitrypsin deficiency is associated with:
A) a family history of emphysema
B) an early onset of dyspnea upon exertion
C) restrictive pulmonary disease
D) bullae in the upper and medial lobe
E) gastrointestinal malabsorption
FM-1.88. Recognized causes of recurrent pneumonia include:
A) chronic alcoholism
B) multiple myeloma
C) hereditary spherocytosis
D) esophageal lesions
E) allergic bronchopulmonary aspergillosis
FM-1.89. Barbiturates, if continuously administered can:
A) contribute to the development of convulsions
B) induce physical dependence
C) cause relaxation of skeletal muscles
D) cause parkinsonism
E) cause ataxia
FM-1.90.
Megaloblastic anemia is a possible side-effect of:
A) carbamazepine therapy
B) primidone (Sertan) therapy
C) methotrexate therapy
D) sulfamethoxazole and trimethoprim (Sumetrolim) therapy
E) ulcerative colitis
FM-1.91.
Drugs which potentiate hypoglycemic attacks developing as a consequence
of sulphonylurea administration are:
A) probenecid
B) sulfamethoxazole and trimethoprim (Sumetrolim)
C) acenocoumarol (Syncumar)
D) monoamino-oxidase inhibitors
E) salicylates
FM-1.92.
Biologically active compounds which are metabolized in the lung include:
A) surfactant
B) kallikrein
C) prostaglandins
D) angiotensin I
E) bradykinin
FM-1.93.
In atrial septal defect:
A) symptoms usually present in the second decade
B) echocardiography reveals dilatation of the pulmonary artery
and the right ventricle
C) a fixed, widely split second heart sound is detected
D) a murmur is caused by the flow through the defect
E) a mid-diastolic murmur, enhanced during expiration, is characteristic
FM-1.94.
In fat embolization:
A) skin hemorrhages forming petechiae are rare
B) cyanosis is present
C) the occurrence of convulsions indicates a poor prognosis
D) intravenous alcohol injection is a possible therapeutic intervention
E) hemoptysis is a common symptom
FM-1.95.
Neurologic manifestations of myxedema include:
A) atrophy of the optic nerve
B) paresthesia of the hands
C) cerebellar symptoms
D) a loss of vibration sensation in the legs
E) hypacusis and tinnitus
FM-1.96.
Possible initial symptoms of diabetes mellitus include:
A) weight gain
B) peripheral vascular disease
C) retinal detachment
D) polyuria and polydipsia
E) severe pruritus
FM-1.97.
Characteristic features/complications of cystic fibrosis include:
A) a decreased chloride concentration of sweat
B) anorexia
C) hepatic cirrhosis
D) chronic paranasal sinusitis
E) a decreased pancreatic enzyme activity in the duodenal juice
FM-1.98.
Carcinoma of the gallbladder:
A) the prevalence is higher in males
B) is associated with cholelithiasis in 90% of cases
C) virtually never causes hepatomegaly
D) the formation of distant metastases is very rare
E) commonly develops from an adenomatous polyp
FM-1.99.
Recognized features of Whipple's disease include:
A) that in most cases it is manifested in young adulthood
B) arthralgia
C) lymphadenopathy
D) a PAS-positive substance in a jejunal biopsy sample
E) an excellent response to a daily dose of 1 g of tetracycline for 3
Weeks
FM-1.100.
Recognized causes of impotency include:
A) a total prostatectomy
B) an androgen deficiency
C) tabes dorsalis
D) parietal lobe lesions
E) malignant hypertension
FM-1.101.
A sudden development of bilateral external ophthalmoplegia is
associated with:
A) botulism
B) myasthenia gravis
C) Wernicke's encephalopathy
D) neurosyphilis
E) diphtheria
FM-1.102.
Which of the following statements concerning paroxysmal myoglobinuria
are correct?
A) the urine is devoid of erythrocytes
B) there is severe muscle weakness
C) renal failure is a possible complication
D) 50% of patients die in an acute attack
E) McArdle's disease is a possible cause
FM-1.103.
Factors directly regulating the renal concentration of urine under
physiological conditions include:
A) the concentration of any circulating antidiuretic hormone
B) the systemic blood pressure
C) normal tubular function
D) a potassium depletion
E) the presence of fever
FM-1.104.
In the nephrotic syndrome:
A) the prognosis is better in males than in female patients
B) a generalized edema is present
C) an intermittent microscopic hematuria suggests advanced
parenchymal damage
D) the administration of steroids is always ineffective
E) favourable treatment includes the management of any underlying
Disease
FM-1.105. Adult type polycystic kidney disease:
A) its inheritance is autosomal recessive
B) is manifested by massive proteinuria
C) is frequently complicated by malignant hypertension
D) polycythemia is a possible complication
E) an ultrasound examination of the kidneys reveals characteristic
changes
FM-1.106.
In infectious endocarditis:
A) the presence of bacteria within the kidney can usually be
demonstrated
B) any renal abnormalities are due to immune complex
glomerulonephritis
C) a real hematuria, if present, is not related to the disease
D) any renal involvement unfavourably alters the outcome of the
disease
E) a persistent hypocomplementemia is always present
FM-1.107.
In acute pyelonephritis:
A) a common symptom is shaking chills
B) vomiting is a possible complaint
C) the absence of any lumbar pain excludes the diagnosis
D) an intravenous pyelogram is necessary for the diagnosis
E) to confirm the diagnosis, a hemoculture should routinely be
made
FM-1.108.
A splenectomy has a beneficial effect in:
A) hereditary spherocytosis
B) idiopathic thrombocytopenic purpura
C) sickle cell anemia
D) thalassemia major
E) hemoglobin H disease
FM-1.109.
Symptoms of the lateral medullary syndrome include:
A) contralateral ataxia
B) Horner's syndrome affecting the ipsilateral side
C) hoarseness of the voice
D) diplopia
E) visual field defects
FM-1.110.
In acute idiopathic polyneuritis:
A) both proximal and distal muscular weakness are present
B) pain is a common feature
C) the occurrence of paresthesias is common
D) urinary retention is a frequent complication
E) lymphadenopathy is a frequent complication
FM-1.111.
Which of the following statements about pellagra are correct?
A) approximately 70% of patients exhibit mental symptoms
B) the excessive consumption of cereals causes this disease
C) an advanced pellagra can be fatal within a few years
D) dermatitis, diarrhea, and dementia frequently develop
E) there is substantial improvement one week after commencing
therapy
FM-1.112.
The prevalence of suicide is higher in:
A) depressive psychosis
B) psychopathic patients
C) obsessive-compulsive neurosis
D) chronic alcoholism
E) epilepsy
FM-1.113.
Factors which stimulate glucagon secretion include:
A) cholecystokinin
B) hypoglycemia
C) secretin
D) alpha-adrenergic stimulators
E) free fatty acids
FM-1.114.
Symptoms of the Hand-Schuller-Christian disease include:
A) diabetes insipidus
B) exophthalmus
C) hypercholesterolemia
D) skull lesions
E) lipemia retinalis
FM-1.115.
Poliomyelitis (cerebral infantile paralysis) is associated with:
A) muscle hypotonia
B) ataxia
C) atethosis
D) bitemporal hemianopsia
E) a severe tremor
FM-1.116.
Characteristics of pediatric viral hepatitis include:
A) it is usually caused by the Hepatitis B virus
B) hepatic cirrhosis is a frequent complication
C) pruritus is a rare outcome
D) splenomegaly; which is more frequent than in adult viral hepatitis
E) acute hepatic failure is a rare outcome
FM-1.117.
A type II (cytotoxic) hypersensitivity reaction is observed in:
A) sumac (Rhus vernix) intolerance
B) idiopathic thrombocytopenic purpura (ITP)
C) Goodpasture's syndrome
D) penicillin allergies
E) chronic mucocutaneous candidiasis
FM-1.118.
Immunosuppressive therapy is suitable in which ofthe following conditions?
A) psoriatic arthritis
B) ileitis regionalis (crohn's disease)
C) persistent viremia
D) rheumatoid arthritis
E) poststreptococcal glomerulonephritis
FM-1.119.
The complications of diphtheria include:
A) a paralysis of the diaphragm
B) airway obstruction
C) bronchopulmonary diphtheria
D) glossopharyngeal neuritis
E) subacute sclerozing panencephalitis
FM-1.120
Tetanus:
A) is caused by an anaerobic gram-positive rod
B) bacterium is shed into the soil through the intestine of
infected animals
C) may cause carpopedal spasm
D) infected patients frequently exhibit mental confusion at admittance
E) urinary retention and constipation may develop
FM-1.121
In primary tuberculosis:
A) alterations usually occur in the lower two thirds of the lungs
B) bilateral hilar adenopathy frequently develops in adolescents
C) miliary tuberculosis might develop
D) eczematous conjunctivitis is a characteristic symptom
E) there is no association with erythema nodosum
FM-1.122.
Characteristics of a Trichinella spiralis infection include:
A) prodromal diarrhea in adults
B) severe muscular pain
C) periorbital edema
D) subconjunctival hemorrhages
E) patchy subungual hemorrhages
FM-1.123.
Myopathy is typically associated with:
A) excessive alcohol ingestion
B) McArdle's disease (phosphorylase deficiency)
C) strychnine poisoning
D) Guillain-Barre syndrome
E) hypothyroidism
FM-1.124.
Which of the following statements concerning silicosis are correct?
A) the latency period is usually short
B) there is a high coincidence rate with scleroderma
C) the prevalence of bronchogenic carcinoma is higher
D) it causes characteristic calcification of the hilar lymph nodes
E) functional respiratory tests reveal an obstructive disorder
FM-1.125.
Bullous skin lesions are observed in which of the following conditions?
A) herpetiform dermatitis
B) a barbiturate overdose
C) Albright's disease
D) ataxia-teleangiectasia
E) pemphigoid
FM-1.126.
Features of galactosemia include:
A) hepatic cirrhosis
B) mental retardation
C) E. coli septicemia
D) that it improves following application of products containing
soybean
E) cataracts which are present at birth
FM-1.127.
Somatostatin:
A) is found in the D cells of the pancreatic islet cells
B) inhibits insulin secretion
C) inhibits glucagon secretion
D) pancreatic tumors secreting somatostatin cause hyperglycemia
E) pancreatic tumors secreting somatostatin cause biliary stones
FM-1.128.
Which of the following findings can be detected in Hodgkin's disease:
A) a normochromic, normocytic anemia
B) an increased erythrocyte sedimentation rate
C) leukocytosis
D) thrombocytosis
E) eosinophilia
FM-1.129.
Trichomoniasis:
A) causes perinatal intertrigo
B) is sexually transmitted
C) causes severe systemic symptoms
D) may be completely symptomless
E) the disease of the newborns is transmitted from the mother
FM-1.130.
Symptoms of a ventricular septal defect include:
A) an elevated jugular vein pressure, even in the absence of
cardiac failure
B) a pansystolic murmur over the apex
C) a systolic ejection murmur
D) a Graham-Steel sound, which is a very common finding following
the development of pulmonary hypertension
E) a fixed, widely split second heart sound
FM-1.131. Infective endocarditis is rarely associated with:
A) combined mitral valvular disease
B) a patent ductus arteriosus
C) cogenital bicuspid aortic stenosis
D) an atrial septal defect
E) advanced mitral stenosis
FM-1.132. In pulmonary atresia:
A) cyanosis is present
B) convulsions may occur
C) a continuous murmur is detected
D) the ECG findings differentiate this condition from Tetralogy of Fallot
E) crouching down relieves the associated symptoms
FM-1.133.
Klebsiella-pneumonia:
A) is usually mild
B) is frequently associated with a collapse of the upper lobe
C) frequently causes lung abscesses
D) despite therapy the mortality is 50%
E) most commonly develops in youngsters
FM-1.134.
Addison's disease can be associated with:
A) Hashimoto's thyroiditis
B) hyperparathyroidism
C) more intensive pigmentation
D) vitiligo
E) calcification of the adrenal gland
FM-1.135.
An association of cholestatic icterus has been noted with:
A) pregnancy
B) methyltestosterone therapy
C) isoniazid therapy.
D) halothane anesthesia
E) biliary cirrhosis
FM-1.136.
Nicotinamide deficiency may cause:
A) high output cardiac failure
B) dementia
C) glossitis
D) sensory polyneuropathy
E) dermatitis
FM-1.137.
The relatives of patients with which of the following diseases must
undergo a screening test?
A) acute intermittent porphyria
B) Wilson's disease
C) hemochromatosis
D) Gilbert's disease
E) chlorpromazine induced cholestatic icterus
FM-1.138.
Which of the following findings would suggest a benign rather than a
malignant paraproteinemia?
A) Bence-Jones proteinuria
B) the IgG level is higher than 2 g/ 100 ml
C) there is an elevated paraprotein level
D) no skeletal abnormalities can be detected
E) a 2-year symptomless period
FM-1.139.
Which of the following statements about nitroglycerin are correct?
A) only topical application is effective in Raynaud's disease
B) it causes paroxysmal nocturnal dyspnea as a side-effect
C) it relieves the pain caused by diffuse esophageal spasms
D) it might relieve pain in biliary colic
E) it alleviates the symptoms of bronchial asthma
FM-1.140.
Which of the following statements concerning doxorubicin
(Adriamycin) therapy are correct?
A) the drug is applied intramuscularly
B) the drug causes myelosuppression
C) the drug causes cardiomyopathy
D) the drug is successful in the treatment of primary
hepatocellular carcinoma
E) the drug should be administered daily, for a period of 21 days
FM-1.141.
A classic type migraine is characterized by which of the following?
A) it cannot be diagnosed if there are no prodromal symptoms
B) it shows a gradual progression
C) a homonymous hemianopsia is present
D) there is edema of the papilla
E) frequently occuring acoustic hallucinations
FM-1.142
Progressive spinal muscular atrophy of infancy is associated with:
A) severe general syncope
B) fasciculation of the tongue
C) a loss of function of the spinothalamic tract
D) spontaneous fibrillation revealed by electromyography
E) normal tendon reflexes
FM-1.143.
The complications of meningococcal meningitis include:
A) hydrocephalus
B) paraparesis
C) cortical blindness
D) deafness
E) peripheral neuropathy
FM-1.144.
In pyloric stenosis of infancy:
A) there is an autosomal dominant imheritance pattern
B) vomiting occurs during the first week of life
C) the vomit is frequently tinged with bile
D) an abdominal tumor is nearly always palpable
E) if left untreated complications during adulthood commonly
develop
FM-1.145.
Which of the following foods should be avoided in celiac disease
(gluten sensitive enteropathy) ?
A) cheese
B) corn flakes
C) rye cereals
D) beer
E) bread
FM-1.146.
Manifestations of congenital rubella include:
A) thrombocytosis
B) retrolental fibroplasia
C) mental retardation
D) microphthalmus
E) macrosomia
FM-1.147.
Causes of mental retardation include:
A) severe malnutrition
B) polyomyelitis
C) 'cri du chat' syndrome
D) a cytomegalovirus infection
E) the presence of syringomyelia
FM-1.148.
Which of the following findings would suggest psychosis of childhood?
A) an inability to speak
B) intense emotional outbreaks
C) recurrent nocturnal enuresis after a toilet-proof period
D) a sensation of depersonalization
E) a sudden onset of dysphemia (stammering)
FM-1.149.
Which of the following observations help to differentiate neurosis
from psychosis?
A) neurotic patients characteristically disclaim reality
B) endogenous experiences cause excitation in neurosis
C) real illusions can occur in neurosis
D) associative function is not affected in neurosis
E) the 'ego' is intact in neurotic patients
FM-1.150.
Which of the following statements about autosomal dominant inheritance
are correct?
A) the likelihood of a manifestation in the offspring is 25%
B) the manifested disease is usually less severe than those which
have the recessive trait
C) manifestation affects several generations
D) healthy parents are carriers
E) the more rare the manifestation, the more likely a genetic
relationship exists in the family
FM-1.151.
Plague:
A) is transmitted by droplet infection
B) usually does not cause fever
C) causes painful enlargement of the lymph nodes
D) causes characterictic circular erythematous skin lesions
E) responds to high dose penicillin therapy
FM-1.152.
In amebic dysentery:
A) symptoms might be similar to those observed in duodenal ulcer
B) alternating diarrhea and constipation suggest an underlying
carcinoma
C) intestinal movements are associated with a characteristic
sweet odor
D) amebiasis of the liver is a rare complication
E) metronidazole (Klion) is the therapeutic drug of first choice
FM-1.153.
Toxocara canis:
A) causes severe pruritus ani
B) causes hepatosplenomegaly
C) may cause asthma
D) the larva respond to diethylcarbamazine
E) causes chronic diarrhea in children
FM-1.154.
Lymphogranuloma venereum:
A) its prevalence is high in temperate zones
B) the Frei-test is frequently positive
C) is caused by Clamydia trachomatis
D) usually causes primary herpetiform lesions
E) causes non-gonococcal urethritis
FM-1.155.
Laboratory findings characteristic for early nephrotic syndrome
include:
A) a serum albumin level which is lower than 25 g/1
B) a decreased fibrinogen level
C) an elevated serum cholesterol level
D) an expanded circulatory volume
E) an increased erythrocyte sedimentation rate
FM-1.156 .
Causes of an increased kidney size include:
A) acute glomerulonephritis
B) polycystic kidney disease
C) chronic glomerulonephritis
D) renal amyloidosis
E) hypertrophy following contralateral nephrectomy
FM-1.157. Possible causes of fibrotic alopecia include:
A) x-ray irradiation
B) alopecia areata
C) discoid lupus erythematosus
D) a post partum state
E) heparinization
FM-1.158.
Infectious mononucleosis is associated with:
A) periorbital swelling
B) generalized lymphadenopathy
C) jaundice in the majority of patients
D) petechiae on the palate
E) pruritus
FM-1.159.
In polycythemia rubra vera:
A) a transient blurring of vision is possible
B) the tendency for thrombosis only affects the veins
FM-1.172.
In "petit mal" epilepsy:
A) a cerebral tumor is observed which is responsible for the
development of the disease
B) breath-holding spells (infantile syncope) are observed
C) the EEG reveals characteristic changes
D) if the disease persists then during adulthood "grand mal"
convulsions may also occur
E) no effective treatment is available
FM-1.173.
Cryptococcus infection:
A) causes the symptoms of meningitis
B) is a frequent complication of AIDS
C) a lung infection might remain localized
D) a common complication is the occurrence of a pleural effusion
E) a typical finding is calcified hilar lymphadenopathy
FM-1.174.
Which of the following tests are valuable in the differential diagnosis
of non-tropical sprue and pancreatic insufficiency?
A) the determination of the urinary indican
B) 14C-D-xylose test
C) the Schilling test
D) the serum albumin concentration
E) the serum cholesterol concentration
FM-1.175.
Which of the following statements about glucagon are correct?
A) its half-life in the circulation is 5-10 hours
B) it is metabolized mainly in skeletal muscle
C) it is secreted into the portal vein
D) it stimulates red blood cell production in the bone marrow
E) it has a gluconeogenic effect
FM-1.176.
Undesirable effects of oxygen inhalation include:
A) pulmonary atelectasis
B) hepatic fibrosis
C) retrolental fibroplasia
D) acute renal failure
E) myocardial damage
FM-1.177.
Which of the following statements about Bence-Jones proteins are correct?
A) if they are present in the urine, the Albustix test is positive
B) the excreted amount increases parallel with the progression of
the renal disease
C) they are rarely detected in benign monoclonal gammopathy
D) in severe cases, hypoproteinemia develops
E) they are light chain proteins
FM-1.178.
Drug induced lupus erythematosus:
A) causes renal failure
B) causes arthritis
C) corticosteroid therapy may be indicated
D) may be caused by pyrazinamide therapy
E) may be caused by hydralazine therapy
FM-1.179.
Radio-opaque renal stones are:
A) calcium oxalate stones
B) xanthine stones
C) uric acid stones
D) cystine stones
E) magnesium ammonium phosphate stones
FM-1.180.
Jaundice and acute renal failure are detected in:
A) amanita phalloides poisoning
B) Gram negative septicemia
C) Weil's disease
D) polycystic kidney disease
E) salicylate intoxication
FM-1.181.
A serum calcium level of 3.0 mmol/1(12 mg%) is possibly detected in:
A) acute alcohol induced pancreatitis
B) multiple myeloma
C) hyperparathyroidism
D) renal tubular acidosis
E) sarcoidosis
FM-1.182.
Hyperuricemia is associated with which of the following conditions?
A) lymphomas
B) hemolysis
C) preeclampsia
D) acute alcohol abuse
E) hypoparathyroidism
FM-1.183.
Which of the following diseases have an autosomal dominant inheritance
pattern?
A) Ehlers-Danlos syndrome
B) homocystinuria
C) hereditary spherocytosis
D) galactosemia
E) Marfan's syndrome
FM-1.184.
Clubbing of the fingers is observed in which of the following conditions?
A) chronic meningococcal meningitis
B) rheumatoid arthritis
C) bronchiectasis
D) schistosomiasis
E) carcinoma of the lung
FM-1.185.
Impetigo:
E) Ebstein's anomaly
FM-1.192.
Symptoms of rickets of infancy include:
A) muscular hypertrophy
B) sweating of the skin of the head
C) craniotabes
D) coxa vara
E) an early closing of the fontanelles
FM-1.193.
The clinical symptoms of idiopathic hypercalcemia of infancy include:
A) severe constipation
B) a low serum cholesterol level
C) a short PQ interval observed on the ECG
D) an irreversible mental retardation
E) hypertension
FM-1.194.
Iron poisoning in children:
A) is less likely to be caused by ferrous gluconate than by ferrous
sulphate
B) causes melena
C) causes jaundice
D) heart failure is a common complication
E) causes respiratory acidosis
FM-1.195.
Which of the following statements about norepinephrine are correct
when compared to epinephrine?
A) a development of hyperglycemia is less likely with
norepinephrine
B) a more pronounced elevation of blood pressure is observed
with norepinephrine
C) a more pronounced increase in peripheral resistance is observed
with norepinephrine
D) norepinephrine markedly increases cardiac output
E) the effect on the free fatty acid liberation is more pronounced
with norepinephrine
FM-1.196.
Which of the following statement about a bicuspid aortic valve is correct?
A) coarctation of the aorta is sometimes associated with this anomaly
B) calcification of the abnormal valve is rare
C) infectious endocarditis is extremely rare
D) incompetence of the valve is more frequent than stenosis of the
valve
E) this anomaly is frequently associated with Turner's syndrome
FM-1.197.
Aortic arteritis (Takayasu's syndrome):
A) a carotid sinus hyperesthesia is present
B) visual symptoms are pronounced
C) cardial insufficiency is rare
D) claudication of the jaw is detectable
E) it is rarely associated with intestinal ischemia
FM-1.198.
An accentuated first heart sound is audible in which of the following
conditions?
A) complete heart block
B) severe mitral regurgitation
C) mitral stenosis
D) acute myocarditis
E) pulmonary embolism
FM-1.199.
Characteristic physical symptoms of pneumothorax include:
A) percussion over the affected side reveals dullness
B) auscultation over the affected side reveals weaker respiratory
sounds
C) end-rspiratory crepitations are detected
D) the mediastinum is shifted towards the opposite side
E) that there are decreased respiratory movements on the affected side
FM-1.200.
Adequate procedures in the treatment of asthmatic crisis include:
A) the inhalation of 40% oxygen if the PaC02 is elevated
B) sedation with pethidine (Dolargan) if the patient is agitated
C) the intravenous administration of hydrocortisone
D) salbutamol inhalation
E) water deprivation for the prevention of cardiac insufficiency
FM-1.201.
Findings and parameters which help to differentiate chronic
bronchitis from emphysema are:
A) prolonged expiration and rales
B) the PaC02
C) the diffusion capacity
D) the Pa02
E) eosinophilia
FM-1.202.
Predisposing factors to thromboembolic disorders are:
A) carcinoma of the pancreas
B) a type O blood group
C) oral contraceptives
D) obesity
E) myocardial infarction
FM-1.203.
Characteristic features of porphyria cutanea tarda include:
A) an inherited predisposition
B) a marked photosensitivity
C) an enhanced response to barbirutrates
D) a chloroquine (Delagf) intake is followed by an exacerbation of
the symptoms
E) exclusively, the excretion of uroporphyrines is markedly elevated
in the urine
FM-1.204.
Drugs which may induce jaundice include:
A) phenelzine
B) rifampicin
C) penicillin allergic reactions
D) chlordiazepoxide (Elenium)
E) novobiocin
FM-1.205.
Which of the following states predispose an affected person to colon
carcinoma?
A) ulcerative colitis
B) chronic giardiasis
C) familial intestinal polyposis
D) Crohn's disease
E) Hirschsprung's disease
FM-1.206.
Symptoms of acute diverticulitis include:
A) alternating constipation and diarrhea
B) severe rectal hemorrhage
C) vitamin B12 deficiency anemia
D) subacute intestinal obstruction
E) melena
FM-1.207.
Which of the following statements about Echinococcus cyst (hydatid
cyst) are correct?
A) it usually occurs in the right lobe of the liver
B) cerebral involvement is possible
C) typically, multiple cysts are present in the liver
D) adequate therapy involves percutaneous aspiration of the cyst
E) formation of cysts in the long bones is an indication for amputation
FM-1.208.
Arnold-Chiari malformation:
A) causes hydrocephalus
B) is frequently associated with syringomyelia
C), is associated with lumbosacral spina bifida
D) is associated with congenital anomalies of the heart
E) causes urinary bladder dysfunction
FM-1.209.
Possible causes of dysphasia include:
A) a left temporal lobe abscess
B) Alzheimer's disease
C) Parkinsonian syndromes
D) motor neuron disease
E) an intracranial tumor
FM-1.210.
Possible causes of a decreased glucose level and an elevated protein
level in the cerebrospinal fluid include:
A) tuberculosis
B) Cryptococcus-meningitis
C) meningitis carcinomatosa
D) sarcoid meningitis
E) Coxsackie-meningitis
FM-1.211.
Which of the following findings would suggest subarachnoid hemorrhage
rather than an artificially sanguineous cerebrospinal fluid?
A) an elevated cerebrospinal fluid pressure
B) the fluid clears up during puncture
C) the obtained fluid does not clot
D) shrunken red blood cells observed under microscope
E) an elevated lactate dehydrogenase activity of the sample
FM-1.212.
Analgesic nephropathy:
A) alterations seen in intravenous pyelography are characteristic
for the condition
B) shows progression even after the discontinuation of the
etiologic drugs
C) is clinically similar to chronic pyelonephritis
D) causes anuria
E) is caused by long term codeine therapy
FM-1.213.
Monoclonal gammopathy is a recognized feature of:
A) systemic lupus erythematosus
B) sarcoidosis
C) myeloma
D) macroglobulinemia
E) benign paraproteinemia
FM-1.214.
Urinary calcium loss is increased in:
A) osteoporosis
B) osteomalacia
C) primary hyperparathyroidism
D) secondary hyperparathyroidism
E) sarcoidosis
FM-1.215.
Hypocomplementemia is a recognized complication of:
A) acute rheumatic fever
B) paroxysmal nocturnal hemoglobinuria
C) nephritis due to an infected ventriculoatrial shunt
D) membranoproliferative glomerulonephritis
E) acute poststreptococcal glomerulonephritis
FM-1.216.
Recognized alterations in the ECG produced by hyperkalemia include:
A) prominent U waves
B) the lack of P waves
C) wide QRS complexes
D) ventricular tachycardia
E) a depression of the ST segment
FM-1.217.
Disadvantages of a preterm delivery include:
A) the increased frequency of an intracranial hemorrhage in the
newborn
Case Study:
A 3-year-old child loses his appetite and subsequently refuses food.
Possible causes include:
A) an early onset of schizophrenia
B) negative behavior
C) daydreaming
D) anorexia nervosa
E) the parents have spoiled the child
FM-1.225.
Characteristics of anorexia nervosa include:
A) a history of self-induced vomiting
B) lethargy and fatigue
C) hirsutism
D) menorrhagia
E) extreme emaciation
FM-1.226.
Erythema multiforme:
A) is frequently caused by a viral infection
B) may be caused by Mycoplasma pneumoniae
C) usually requires systemic steroid therapy
D) develops in patients with sarcoidosis
E) develops following steroid therapy
FM-1.227.
Skin lesions associated with syphilis are:
A) copper colored bullous lesions
B) unilateral hyperkeratosis of the sole
C) condyloma acuminatum
D) mucocutaneous lesions
E) moderately elevated circular ulcerations
FM-1.228.
Chlorpromazine:
A) inhibits the responsiveness of the reticular activating system
B) causes mydriasis
C) causes an elevation of body temperature
D) causes postural hypotension
E) causes galactorrhea
FM-1.229.
Indications for steroid therapy include:
A) atopic dermatitis
B) sarcoidosis
C) Cushing's syndrome
D) pemphigoid
E) hereditary spherocytosis
FM-1.230.
Diazoxide:
A) is a member of the thiazide diuretics family
B)is suitable for the treatment of insulin secreting tumors
C) is administered intravenously only
D) causes alopecia
E) is suitable for the long-term treatment of hypertension
FM-1.231.
Rales revealed by auscultation are characteristic for:
A) the early phase of pneumonia
B) fibrotizing alveolitis
C) bronchiectasis
D) left ventricular failure
E) chronic bronchitis
FM-1.232.
Papilledema occurs frequently in patients with:
A) Friedreich's ataxia
B) subarachnoid hemorrhage
C) acute meningitis
D) a cerebellar tumor
E) a tumor of the fourth ventricle
FM-1.233.
Clinical symptoms of cretinism are:
A) obesity
B) goiter
C) spastic diplegia
D) deafness
E) mental deficiency
FM-1.234.
Recognized causes of the lack of antidiuretic hormone include:
A) a suprasellar tumor
B) healed tuberculous meningitis
C) phenylbutazone therapy
D) dicoumarol
E) probenecid
FM-1.235.
Which of the following conditions or drugs inhibit uric acid
reabsorption?
A) low dose salycilate
B) hyperlactacidemia
C) phenylbutazone
D) dicoumarol
E) probenecid
FM-1.236.
Recognized causes of a radiologically detected paraspinal calcification
include:
A) fluorosis
B) rickets
C) hypoparathyroidism
D) familial hypophosphatemia
E) thyrotoxicosis
FM-1.237.
Which of the following may cause pain in the heel?
A) ankylosing spondylitis
B) Khler's disease
C) rheumatoid arthritis
45.CDE
46.ABC
47.ABCD
48.ABD
49.BD
50.CDE
51.AC
52.BCE
53.ACD
54.AC
55.BCD
56.BCE
57.ABCDE
58.ACD
59.ABCDE
60.AC
89.BCE
90.ABCD
91.ABCDE
92.ABCDE
93.BC
94.BCE
95.BCE
96.DE
97.CDE
98.B
99.BCD
100.ABC
101.ABC
102.ABCE
103.ACDE
104.BE
133.C
134.ACDE
135.ABE
136.BCE
137.ABC
138.DE
139.ACD
140.BC
141.BC
142.ABD
143.ABD
144.D
145.CDE
146.CD
147.ACD
148.ABD
177.BCE
178.BCE
179.ADE
180.ABC
181.BCE
182.ABCD
183.ACE
184.CE
185.ABC
186.AE
187.BCD
188.CD
189.BCE
190.ABCE
191.ADE
192.BCD
221.BCE
222.ADE
223.CE
224.BCE
225.AE
226.AB
227.ABDE
228.BDE
229.ABD
230.AB
231.BCE
232.BDE
233.CDE
234.ABE
235.CDE
236.ABCD
17.ACE
18.CD
19.ACE
20.AE
21.ACE
22.ABE
23.ACE
24.AC
25.C
26.ACE
27.ACE
28.CD
29.ACDE
30.BDE
31.BCE
32.AB
33.ABD
34.BCDE
35.ABDE
36.ABC
37.ADE
38.ABC
39.AD
40.BCD
41.AB
42.BCE
43.AD
44.BCE
61.CD
62.ABCDE
63.BD
64.BCE
65.BC
66.ABC
67.BD
68.BCE
69.AC
70.ACD
71.BCE
72.ABD
73.ABC
74.B
75.ACE
76.ABCD
77.ACD
78.CDE
79.ACD
80.C
81.ACE
82.ABCD
83.CDE
84.C
85.ACDE
86.ABCDE
87.AB
88.ABDE
105.DE
106.B
107.AB
108.AB
109.BCD
110.ACD
111.CD
112.ABD
113.AB
114.ABD
115.ABC
116.CE
117.BC
118.AD
119.ABCD
120.ABE
121.ACD
122.ABCDE
123.ABE
124.BD
125.ABE
126.ABC
127.ABCDE
128.ABCDE
129.ABD
130.C
131.DE
132.ABCE
149.DE
150.BC
151.AC
152.AE
153.BCD
154.CDE
155.AC
156.ABDE
157.AC
158.ABD
159.ACD
160.DE
161.ABE
162.C
163.AE
164.BD
165.E
166.BCE
167.ABD
168.BC
169.BCD
170.BCD
171.ABCD
172.CD
173.ABC
174.BCD
175.CE
176.AC
193.ACDE
194.ABC
195.BD
196.A
197.ABDE
198.CE
199.BDE
200.C
201.ABCD
202.ACDE
203.ABDE
204.ABCDE
205.AC
206.ABD
207.ABE
208.ABC
209.ABE
210.ABCD
211.ACD
212.ACD
213.CDE
214.CE
215.CDE
216.BCD
217.ACE
218.ACD
219.AC
220.BE
PBH-2.1.
Which of the following statements regarding perinatal mortality is
true?
A) the fetal mortality rate plus the number of fatalities among
live-born neonates within the first 6 days of life
B) the number of fatalities within the first 27 days of life
C) the number of abortions plus the fetal mortality rate (including
the number of fatalities within the first 6 months of life)
D) mortality occurs within the first year of life
PBH-2.2.
The most frequently used indicator for the quality of life is:
A) the life expectancy rate at birth
237.ACE
238.ACD
239.ACDE
240.ABD
241.BCE
D) accidents
PBH-2.16.
Alcohol and drug abuse:
A) are equally prevalent in both sexes
B) are more prevalent among males
C) are more prevalent among females
D) have an age-dependent prevalence
PBH-2.17.
The time to seek needed medical help is determined by:
A) the personality of the given individual
B) the intensity of the signs and symptoms
C) the pain-sensitivity of the individual
D) all of the above
E) none of the above
PBH-2.18.
All of the following are characteristic features of drug dependence,
EXCEPT:
A) anxiety and nervous behavior
B) excessive smoking
C) weight gain
D) poor personal hygiene
PBH-2.19.
Which of the following is used as health indicators of a population?
A) demographic parameters
B) somatometric parameters
C) epidemiologic parameters
D) all of the above
E) none of the above
PBH-2.20.
The principal cause of the population reduction in Hungary is:
A) a low live birth rate
B) the significant reduction of the live birth rate as compared to
the European average
C) a stagnant mortality rate
D) the deterioration of raw mortality statistics
PBH-2.21.
A pyramid shaped age distribution tree is characteristic of countries with:
A) an increasing population
B) a decreasing population
C) a stagnant population
PBH-2.22.
Where is the World Health Organization's principle headquarters?
A) London
B) Geneva
C) New York
D) Vienna
PBH-2.23.
All of the following are important factors for studies on lifestyle,
EXCEPT.
A) smoking
B) alcohol consumption
C) eating habits
D) drug abuse
E) the social support system
F) physical activity
G) health beliefs
PBH-2.24.
The initiative "Health for all" means:
A) the achievement of a health level that ensures complete physical,
mental, and social well being
B) the achievement of a health level that is based on the rights
and responsibilities of the individual as well as the society
C) the achievement of a health level that ensures complete physical,
mental, and economic well being
D) the provision of a health level that ensures a socially and financially
productive life for every individual
PBH-2.25.
Which of the following is used for the classification and comparison
of the various disease processes?
A) the international classification of diseases (ICD)
B) the international classification of death causes
C) the international classification of death causes, diseases, and
symptoms
PBH-2.26.
The term "lethality" means:
A)the intensity of a disease
B) the ratio of fatal cases among patients with the given disease
C) the mortality rate of a given disease
D) the morbidity conditions of a given disease
PBH-2.27.
The WHO Center for the European Region resides in:
A) Geneva
B) Paris
C) Copenhagen
D) Rome
PBH-2.28.
All of the following belong to the methods of health education, EXCEPT:
A) the health education of the individual
B) the health education of the community
C) printed health education materials
D) health education via the mass media
PBH-2.29.
Epidemiology can be regarded as the study of
A) the etiology of human diseases
B) the incidence and causes of human death
C) the distribution of human diseases and the incidence of their
determining factors
D) the functional parameters of the health care delivery system
PBH-2.30.
Which of the following statements regarding the infant mortality rate
is correct?
A) the numerator contains the number of neonates who died during
the first month of life
B) this is the ratio of neonatal deaths during the first week of life
per thousand live births
C) this is the ratio of infant deaths during the first year of life per
thousand live births
PBH-2.31. According to 1990 data, which of the following is the closest approximation
of the live birth rate in Hungary?
A) 19.5%
B) 17.2%
C) 12%
D) 9.7%
PBH-2.32.
According to 1990 data, which of the following is the closest approximation
of the raw mortality rate in Hungary?
A) 19.2%o
B) 18.7%o
C) 16.5%o
D) 14.1%o
PBH-2.33.
According to 1990 data, the life expectancy of males born in Hungary is:
A) 66.1 years
B) 65.1 years
C) 62.2 years
D) 63.1 years
PBH-2.34.
Compared to developed countries, Hungary's ranking in the raw
mortality rate is:
A) in the middle third of the list
B) in the upper third of the list
C) in the lower third of the list
D) the country with the highest raw mortality rate
PBH-2.35.
Which of the following parameters regarding the male gender is similar
or worse than corresponding data from three decades back?
A) the raw mortality rate
B) the life expectancy at birth
C) the standardized mortality rate
D) the life expectancy after 40 - 50 years of age
PBH-2.36.
All of the following belong to the new methods of population science
used for setting priorities and making decisions, EXCEPT:
A) the magnitude of the potential loss of live years
B) the standardized age and gender specific mortality
C) the life expectancy without disability
D) the number of live years afflicted by disability and chronic disease
PBH-2.37.
All of the following are the most frequent causes of death in Hungary,
EXCEPT:
A) cardiovascular disesases
B)death due to trauma
C) congenital malformations
D) malignancies
PBH-2.38.
According to the results of the "KOMOV Study", all of the following
belong to the 3 most frequent ICD main groups in Hungary, EXCEPT:
A) skin and connective tissue diseases
B) upper respiratory tract and respiratory system diseases
C) cardiovascular diseases
D) gastrointestinal diseases
PBH-2.39.
According to the results of the "KOMOV Study", what is the approximate
percentage of the population in need of continuous follow-up
care?
A) 15%
B) 25%
C) 40%
D) 60%
PBH-2.40.
What is the percentage of males living into their sixth decade of life
as economically active citizens in Hungary?
A) 35%
B) 45%
C) 57%
D) 62%
PBH-2.41.
Compared to the percentage of smokers in the population in seventeen
other European countries, Hungary:
A) is ranked in the lower third of the field
B) is ranked in the middle third of the field
C) is ranked among the leading countries
D) has the least favourable statistics
PBH-2.42.
All of the following are features of health beliefs, EXCEPT:
A) the public opinion regarding the determining factors about the
status of health
B) the individual's opinion about the problems associated with
his/her disease
C) the individual's attitude toward the health care delivery system
D) the individual's opinion regarding the use of preventive and
early health care interventions
PBH-2.43. All of the following blood pressure readings indicate the presence of
hypertension, EXCEPT:
A) 160/95 mmHg
B) 145/89 mmHg
C) 170/90 mmHg
D) 200/97 mmHg
PBH-2.44.
The proportion of essential (primary) hypertension among all hypertension
cases is as high as:
A) 25-30%
B) 40-45%
C) 60-65%
D) 90-95%
PBH-2.45.
All of the following are valid statements regarding the significance of
hypertension, EXCEPT:
A) it is the most prevalent disease in the main group of cardiovascular
disorders
B) absenteeism from work associated with cardiovascular disorders
is mainly due to hypertension
C) it is a prevalent cause of death in the mortality statistics
D) hypertension is extremely demanding on nursing and health
care facilities
PBH-2.46.
All of the following are parts of the proper technique for taking accurate
blood pressure readings, EXCEPT:
A) the blood pressure should be measured in the sitting position
and the patient should not have smoked or consumed coffee in
the preceding hour
B) the actual blood pressure is determined by averaging 3 pressure
readings
C) the actual blood pressure is determined by averaging 2 pressure
readings
D) the width of the cuff used should match the circumference of
the upper arm
PBH-2.47.
Which of the following statements is FALSE?
A) the prevalence of hypertension in the Hungarian population
aged 18-64 years is approximately 20%
B) the prevalence of hypertension is higher in the rural population
than in the urban population
C) the prevalence of hypertension is higher in males than in females
D) the incidence of hypertension increases with advancing age
PBH-2.48.
All of the following are risk factors for hypertension, EXCEPT:
A) a high bodyweight
B) a hereditary disposition
C) an excessive intake of sodium
D) the regular use of alcohol
E) smoking
PBH-2.49.
All of the following statements regarding stroke are valid, EXCEPT:
A) stroke is more prevalent in males
B) the stroke related mortality rate is less in females than in males
B) gonorrhea
C) chancroid
D) syphilis
PBH-2.63.
In Hungary, during the period from 1970 to 1988, the mortality rate
due to chronic liver disease and cirrhosis:
A) had not changed significantly
B) had decreased by 50%
C) had decreased by more than 50%
D) had doubled
E) had increased more than five-fold
PBH-2.64.
Anal-oral transmission is characteristic of:
A) hepatitis B
B) hepatitis C
C) hepatitis D
D) hepatitis E
PBH-2.65.
Primary hepatocellular carcinoma may develop in:
A) hepatitis E
B) hepatitis D
C) hepatitis C
D) hepatitis B
PBH-2.66.
The application of gamma-globulin (immunoglobulin) currently
manufactured in Hungary is effective for post-exposure protection
in:
A) a hepatitis A infection
B) a hepatitis B infection
C) a hepatitis C infection
D) a hepatitis D infection
E) none of the above
PBH-2.67.
In Hungary, the mortality rate due to malignant disease is:
A) 31%
B) 40%
C) 15%
D) 5%
PBH-2.68.
In Hungary, the mortality rate resulting from malignant disease is
highest in tumors of the:
A) stomach
B) large intestine
C) rectum
D) lung
PBH-2.69.
Which of the following malignancies is characterized by a decreasing
mortality rate and an increasing rate of incidence?
A) neoplasms of the stomach
A) nursing equipment
B) medical instruments and devices
C) contaminated hands of the staff
D) ambient air
PBH-2.77.
Which of the following nosocomial infections is the most common in
Hungary?
A) pneumonia
B) surgical wound infections
C) septic conditions
D) urinary tract infections
PBH-2.78.
Which of the following microorganisms is the most common pathogen
of nosocomial infections?
A) Staphylococcus aureus
B) Streptococcus faecalis
C) Klebsiella sp.
D) E. coli
PBH-2.79.
Which of the following hospital departments is afflicted by the highest
relative incidence of nosocomial infections?
A) hospital nurseries
B) intensive care units
C) departments of surgery
D) departments of urology
PBH-2.80.
What is the approximate proportion of infectious hepatitis cases
among the occupational nosocomial infections?
A) 20%
B) 40%
C) 60%
D) 80%
PBH-2.81.
Which of the following extrinsic factors is considered the most significant
factor of carcinogenesis in Hungary?
A) nutrition
B) smoking
C) occupational diseases
D) enviromental pollution
PBH-2.82.
What is the mortality rate of rabies?
A) 20-40%
B) 50-60%
C) 70-80%
D) 100%
PBH-2.83.
Which of the following diets would you recommend to an asymptomatic
male with moderate hypercholesterolemia?
A) stuffed eggs, and mixed salads
B) lung cancer
C) cervical cancer
D) colon cancer
PBH-2.91.
Case Study:
Several patients present at your office simultaneously, with symptoms
occurring 2-3 hours after a meal. Their complaints include malaise,
nausea and vomiting although they have no fever. Which of the
following food-poisonings is the likely cause of this condition?
A) botulism
B) salmonellosis
C) staphylococcal food poisoning (caused by S. aureus)
D) Clostridium perfringens food poisoning
PBH-2.92.
Which of the following may cause cancer of the urinary bladder?
A) cadmium
B) mercury
C) aniline dyes
D) lead
PBH-2.93.
What is the optimal percentage of protein-calories in the total energy
content of a balanced diet?
A) 6-10%
B) 10-12%
C) 12-18%
D) 25-30%
PBH-2.94.
The purpose of the medical booklet issued to workers employed in
the food processing and public catering industry is to:
A) educate employees on the prevention of food poisoning
B) provide a means for registering their experience gained during
hygienic surveys
C) to demonstrate the mandatory food-hygienic regulations to the
people employed in food processing or catering
D) to keep record of the results of the medical tests mandatory in
this profession
PBH-2.95.
Which of the following laboratory tests is valuable in establishing a
diagnosis of echinococcosis?
A) a complete blood count
B) stool tests
C) serologic tests
D) testing of the cerebrospinal fluid
PBH-2.96.
In which of the following types of food poisonings should a blood
sample be sent to the laboratory for examination?
A) staphylococcal food poisoning
B) botulism
C) campylobacteriosis
D) salmonellosis
PBH-2.97.
What is the maximum nitrate concentration of drinking water appropriate
for consumption by infants?
A) 40 ug/1
B) 80 ug/l
C) 40 mg/l
D) 80 mg/1
PBH-2.98.
What is the maximum average noise level allowed for working in a
contionuousl high-level noisey industrial environment?
A) 75 dB
B) 85 dB
C) 90 dB
D) 95 dB
PBH-2.99.
Workers are required to wear individual ear protectors at noise levels
exceeding:
A) 60 dB
B) 75 dB
C) 85 dB
D) 95 dB
PBH-2.100.
Initial hearing-loss resulting from exposure to noise is detectable at
a freqency of:
A) 1000 Hz
B) 2000 Hz
C) 3000 Hz
D) 4000 Hz
PBH-2.101.
The pathomechanism of respiratory conditions caused by vegetable
dust include(s):
A) the allergenic properties of the dust
B) the inflammatory effects of fungi and bacteria
C) both of the above
D) none of the above
PBH-2.102.
Contraindications to post-exposure active immunization for rabies
include(s):
A) pregnancy
B) rheumatoid arthritis
C) active tuberculosis
D) all of the above
E) none of the above
PBH-2.103.
The recent fecal contamination of drinking water is suggested by a
high concentration of.
A) chloride
B) nitrate
C) sulphate
D) ammonia
E) nitrite
PBH-2.104.
Hemangiosarcoma may develop as a result of prolonged exposure to:
A) asbestos
B) polyvinylchloride (PVC)
C) beryllium
D) chlorinated hydrocarbons
PBH-2.105.
Which of the following statements is valid?
A) behavior involves deliberate actions determined by the will and
character of the individual
B) behavior is a learned and acquired pattern of actions that is not
incompatible with the mastering of a contrary or alternative
behavior
C) instead of applying a step-by-step approach, behavior modification
is based on the "all or nothing" principle
PBH-2.106.
The term "compliance" means:
A) the totality of factors influencing health and behavior
B) the atmosphere determining the doctor-patient relationship.
C) the willingness of the patient to cooperate with the health deli
ery system in health development and disease prevention as well
as to facilitate the healing process
PBH-2.107.
Appropriate measures mandatory for the detection of cholera cases include:
A) in cholera, both the occurrence of the infection and the recovery
of the patient should be reported to the public health authorities
B) the detection of the infection should be reported by telegram and
telephone to the regional center of the National Public Health
and Medical Officer Service
C) the detection of the infection should be reported by telegram
and telephone to the National Institute of Public Health
D) all the above should be effected
PBH-2.108.
The hepatitis A virus can be isolated from the stool of an infected
individual:
A) immediately after the onset of jaundice
B) a week before the onset of jaundice
C) only during the period of jaundice
D) 2-3 weeks before the onset of jaundice
PBH-2.109.
A child with polio should be isolated:
A) at home
B) in the hospital (in the department of infectious diseases)
C) no isolation is necessary
PBH-2.110.
Coxsackie and Echovirus infections should be reported if:
A) herpangina develops
B) Reiter's protein
C) immobilizin
D) AFP
PBH-2.126.
Valid statements regarding the incidence and mortality rate of
iatrogenic infections in Hungary include:
A) their incidence is the same as the European average; a mortality rate of 10%
B) their incidence is the same as the European average; a mortality
rate of 1.1- 2%
C) their incidence is lower than the European average; a mortality rate of 3%
D) their incidence is higher than the European average; a mortality
rate of 1.2%
PBH-2.127.
The mechanism of the development of resistance to antibiotics includes
the transmission of the resistance factor by:
A) bacteriophages
B) viruses
C) plasmids
D) lysogenic conversion
PBH-2.128.
The occurrence of iatrogenic infections:
A) does not need to be reported
B) is only useful as a statististical parameter
C) should be reported in the same manner as the patient's recovery
PBH-2.129.
According to 1979 statistics, what was the percentage of iatrogenic
staphylococcosis?
A) 39%
B) 29%
C) 50%
D) 10%
PBH-2.130.
Streptococcus pyogenes is the pathogen of:
A) a puerperal infection
B) diarrhea outbreaks in hospitals
C) pemphigus
D) Lyell's syndrome (toxic epidermal necrolysis)
PBH-2.131.
Typhoid carriers should be followed-up for more than a year:
A) if the carrier state persists longer than a year since the onset
of the infection
B) if the results of stool cultures performed to exclude a carrier
state were positive
C) if new cases have been detected in the carrier's environment
D) and also be classified as chronic enteric carriers of the pathogen
PBH-2.132.
Starting from the date of the last positive stool culture, a typhoid
carrier is obliged to present for laboratory tests:
PBH-2.147.
All of the following are characteristic features of Clostridium
botulinum, EXCEPT:
A) this bacterium is a 1x4 um rod
B) it forms spores
C) this is a Gram-negative bacterium
D) it contains O and (type-specific) H antigens
PBH-2.148.
Characteristic features of botulism include that:
A) the mortality rate of the disease is 80%
B) the length of the incubation period is 3-4 days
C) the mortality rate of the disease is 30-50%
D) the patient must be isolated
PBH-2.149.
In infectious mononucleosis, preventive measures include that:
A) the patient should be isolated
B) laboratory testing is mandatory
C) reporting is not required
D) continuous disinfection is necessary
PBH-2.150.
In enteric fever caused by S. paratyphi, the length of the incubation
period is:
A) 1- 4 days
B) 3-14 days
C) 14 -21 days
D) 21-30 days
PBH-2.151.
One of the administrative steps required in enteric fever caused by
S.paratyphi is:
A) reporting the occurrence of infection
B) reporting the recovery of the patient
C) reporting both the occurrence of the infection and the recovery
of the patient
D) reporting both the occurrence of the infection and the recovery
of the patient; the regional infectious disease control board should
be notified by telephone
PBH-2.152.
Which of the following statements regarding the viability of Shigella
species is valid?
A) in stool, these microorganisms remain viable for several weeks
B) in water and ice, these microorganisms remain viable for 1-2 days
C) encrusted on textiles contaminated by feces, these microorganisms
remain viable for a period longer than 100 days
D) these pathogens are extremely resistant to antiseptic solutions
PBH-2 153.
Proper administrative measures necessary in dysentery include:
A) reporting both the occurrence of the infection and the recovery
of the patient
B) only the reporting of the occurrence of the infection is important
A) quarantined
B) put under observation
C) checked for infection
D) put under partial quarantine
PBH-2.168.
Any persons who have had contact with patients having typhoid fever
should have:
A) stool and urine cultures taken, which should be repeated at 3-day
intervals
B) stool and urine cultures taken, which should be repeated at
3-day intervals and which should yield negative results on at
least 3 occasions
C) stool and urine cultures taken, which should be repeated repeated
at 3-day intervals and which should yield negative results
on at least 2 occasions
D) all these tests taken and which should be performed during
the first week of observation
PBH-2.169.
Typhoid fever (Salmonella typhosa) carriers:
A) may be declared non-infective if the follow-up tests have
yielded negative results for 3 months
B) may be started on conclusive tests for the assessment of
infectivity, if the follow-up tests have yielded negative results for 6 months
C) may be started on conclusive tests for the assessment of
infectivity, if the follow-up tests have yielded negative results for 10 months
D) should be immunized
PBH-2.170.
The tests for the conclusive assessment of the infectivity of typhoid
carriers include:
A) stool and urine cultures performed on consecutive weeks
B) stool and urine cultures performed on 8 consecutive weeks
C) stool and urine cultures performed on 10 consecutive weeks
D) stool and urine cultures as well as the analysis of the duodenal
contents performed on 10 consecutive weeks
PBH-2.171.
The complement system is a component of
A) the immune system
B) the reticuloendothelial system
C) the aspecific host defence system
D) none of the above
PBH-2.172.
Lymphokines are produced by:
A) B lymphocytes
B) T lymphocytes
C) macrophages
D) plasma cells
PBH-2.173.
The phage receptors are:
A) macrophage receptors
B) bacteriophage receptors
C) Bdellovibrio receptors
D) plasmid receptors
PBH-2.174.
Which of the following is a cross-reaction (heterophilic agglutination)?
A) Sabin-Feldmann's reaction
B) Weil-Felix reaction
C) Stein-Leventhal reaction
D) Widal's test
PBH-2.175.
Chronic carriers of typhoid fever:
A) still shed pathogens 4 weeks after recovery but for a period
shorter than a year
B) still shed pathogens 1 year after recovery
C) shed pathogens during the period of recovery
D) still shed pathogens 4 weeks after recovery but stool cultures
turn negative thereafter
PBH-2.176.
Aeroplanktones are adsorbed to:
A) fluid particles only
B) solid particles only
C) both of the above
D) none of the above
PBH-2.177.
The index of contagiousness:
A) is the same as the infectivitiy index
B) represents the prevalence of cases among 100 individuals exposed
to the infective agent
C) represents the number of cases among 100 persons who have
contacted an infected patient
D) is the same as the Pearl index
PBH-2.178.
Vaccines to be administered according to a continuous immunization
schedule include:
A) age-specific, mandatory immunizations
B) seasonal immunizations
C) immunizations required to travel abroad
D) campaign immunizations
PBH-2.179. Components of the chemotherapeutic index include:
A) the toxic dose
B) the DL50 value
C) both the tolerated and the toxic dose
D) both the tolerated and the curative dose
PBH-2.180.
Which of the following authorities should be notified about the occurrence
of an infectious hepatitis infection in Hungary?
A) the National Public Health and Medical Officer Service (NPBHMOS)
B) the NPBHMOS and the National Institute of Public Health
C) the NPBHMOS and the Szt. Laszlb Hospital in Budapest
D) the NPBHMOS and the National Institute of Hematology
PBH-2.181.
All of the following are anthropozoonoses, EXCEPT:
A) listeriosis
B) brucellosis
C) ornithosis
D) tularemia
E) glanders
F) leptospirosis
G) plague
H) anthrax
I) ankylostomiasis
PBH-2.182.
The portal of entry for the tetanus pathogen is:
A) the oral mucosa
B) the conjunctiva
C) the excoriated skin
D) the gastrointestinal tract
PBH-2.183.
The length of the incubation period and the subsequent mortality
rate in a malignant pustule is:
A) 2 days and 50% respectively
B) 14 days and 30% respectively
C) 6 hours - 6 days and 100% respectively
D) 6 hours - 6 adys and 20-60% respectively
PBH-2.184.
The prevalence of trichomoniasis in the Hungarian population is:
A) 10%
B) 2%
C) 50%
D) 20-30%
PBH-2.185.
The prevalence of trichinellosis in the Hungarian population is:
A) approximately 1.5%
B) approximately 3%
C) nil
D) approximately 10%
PBH-2.186.
Creutzfeldt-Jakob disease:
A) has never occurred in Hungary
B) was first described in Hungary
C) also occurs in Hungary
D) only one case has been detected in Debrecen, Hungary
PBH-2.187.
Oncogenic viruses:
A) contain a viral oncogene
B) contain a cellular oncogene
C) are the result of genetic manipulation
D) play an established role in oncogenesis
PBH-2.188.
Serum hepatitis corresponds to:
A) hepatitis A
B) hepatitis B
C) non-A non-B hepatitis
D) chronic aggressive hepatitis
PBH-2.189
Imission:
A) is the same as emission but is expressed by other dimensions
B) represents the distribution of an air pollutant just above the
ground
C) translated word for word, this, term means "introduction"
D) is the initial phase of smog
PBH-2.190.
An aerosol:
A) is "settling" dust
B) is "floating" dust
C) is of a liquid state
D) consists of nitrous oxides
PBH-2.191.
Which of the following belongs to the PAN substances?
A) ozone
B) sulphur dioxide
C) aluminium hydroxide
D) carbon monoxide
PBH-2.192.
Which of the following conditions is described by the idiom "mad as a
hatter"?
A) lead poisoning
B) cadmium poisoning
C) mercury poisoning
D) beryllium poisoning
PBH-2.193.
Moeller-Barlow disease is caused by a deficiency of.
A) vitamin A
B) vitamin D
C) vitamin K
D) vitamin C
PBH-2.194.
The increased degradation of structural proteins results from a
deficiency of
A) calcium
B) potassium
C) magnesium
D) sodium
PBH-2.195.
In Hungary, iodinated salt has been available since:
A) 1960
B) 1940
C) 1950
D) 1965
PBH-2.196.
The development of caries is actively facilitated by:
A) Streptococcus faecalis
B) Streptococcus viridans
C) Streptococcus mutans
D) Streptococcus pyogenes
PBH-2.197.
A major metabolite of aflatoxin is:
A) aflatoxin G1
B) aflatoxin G2
C) aflatoxin M1
D) aflatoxin D2
PBH-2.198.
Gannister disease is caused by the chronic inhalation of:
A) asbestos
B) automobile fumes
C) the dust of fire clay
D) common house dust
PBH-2.199.
The "ADI" value of foods means the permitted concentration of:
A) chemical contamination
B) biological contamination
C) parasitic contamination
D) radionuclide contamination
PBH-2.200.
Judged by its public health conditions, Hungary belongs to the:
A) category of developed countries
B) category of developing countries
C) transitional zone between developed and developing countries
PBH-2.201.
The first step of prevention in human genetics is:
A) screening for genetic defects
B) controlling the consequences of mutations
C) the recognition and research of various mutagenic agents
D) the study of mutagenic agents
PBH-2.202.
Gerohygiene utilizes the results of all the following disciplines, EXCEPT:
A) geriatrics
B) gerontology
C) experimental gerontology
D) social gerontology
PBH-2.203.
Vitamin K is involved in the synthesis of.
A) l coagulation factor
B) 2 coagulation factors
C) 3 coagulation factors
D) 4 coagulation factors
PBH-2.204.
Which of the following refers to beriberi?
A) cuorin
B) kakke
C) itai-itai
D) minamata
PBH-2.205.
Cheilosis develops as a result of:
A) a vitamin D deficiency
B) a vitamin A deficiency
C) a vitamin C deficiency
D) a riboflavin deficiency
PBH-2.206.
Corn contains the antimetabolite:
A) ethobrom
B) indole acetate
C) convertin
D) tryptophan
PBH-2.207.
Tropical sprue develops as a result of.
A) a panthotenic acid deficiency
B) a vitamin B12 deficiency
C) a folic acid deficiency
D) a vitamin A deficiency
PBH-2.208.
Kwashiorkor predominantly afflicts:
A) neonates
B) adults
C) elderly individuals
D) toddlers
PBH-2.209.
Marasmus predominantly afflicts:
A) infants
B) adults
C) children
D) neonates
PBH-2.210.
The "wear quota" (minimum allowance) represents:
A) the absolute minimum of the daily carbohydrate allowance
B) the absolute minimum of the daily fat allowance
C) the absolute minimum of the daily protein allowance
D) weight-loss at high temperatures
PBH-2.211.
Vitamin A deficiency results in:
A) keratomalacia
B) polyneuritis
C) anemia
D) ossification disorders
PBH-2.212.
Rachitis tarda is characteristic in:
A) the adult age
B) the neonatal age
C) puberty
D) advanced age
PBH-2.213.
One gram of fat yields:
A) 39.06 KJ energy
B) 17.20 KJ energy
C) 22.50 KJ energy
D) 20.37 KJ energy
PBH-2.214.
Ethionine is an:
A) antihistamine
B) antivitamin
C) amino acid antagonist
PBH-2.215.
The Minnesota-study:
A) screens for hypertension
B) surveys for myocardial infarction
C) is a model of acute starvation
D) is a model of chronic starvation
PBH-2.216.
Which of the following is the so-called "semiessential" amino acid?
A) arginine
B) cystine
C) tyrosine
D) histidine
PBH-2.217.
The most significant complication of asbestosis is:
A) tuberculosis
B) laryngeal cancer
C) bronchial cancer
D) Raynaud's syndrome
PBH-2.218.
The additive effects of two different poisons having entered the organism
is referred to as:
A) interaction
B) antagonism
C) summation
D) synergism
PBH-2.219.
A level of multiphasic carcinogenesis is:
A) syncarcinogenesis
B) cocarcinogenesis .
C) the promotional phase
PBH-2.220.
Lead inhibits the activity of all the following enzymes involved in the
biosynthetic pathway of heme formation, EXCEPT:
A) d-amino-levulinate dehydratase
B) coproprophyrinogen decarboxylase
C) ferrochelatase
D) heme reductase
PBH-2.221.
Considering the low success rate of therapy in affected cancer patients
already detected by screening, primary prevention is particularly
important in:
A) skin cancer
B) breast cancer
C) bronchial cancer
D) rectal cancer
E) cervical cancer
PBH-2.222.
Which of the following cancers is characterized by a decreasing rate
of incidence both in developed countries and in Hungary?
A) prostatic cancer
B) carcinoma of the colon
C) rectal cancer
D) gastric cancer
E) bronchial-lung cancer
PBH-2.223.
According to 1988 data, mortality due to malignancy was the highest
in:
A) Austria
B) Greece
C) Finland
D) Hungary
E) Sweden
PBH-2.224.
According to 1990 data, mortality due to suicide was the lowest in:
A) Austria and Ireland
B) Austria and Hungary
C) Ireland and Spain
D) Austria and Spain
PBH-2.225.
According to 1990 data, which of the following listed in decreasing
order, ranks the specified countries by mortality due to suicide?
A) Hungary, Ireland, Austria
B) Hungary, Spain, Ireland
C) Hungary, Austria, Ireland
D) Ireland, , Spain, Austria
E) Spain, Austria, Ireland
PBH-2.226.
In Hungary, the number of HIV-positive individuals is as high as:
A) 30
B) 3000
C) 300
D) 30,000
PBH-2.227.
The HIV virus is synergistic with all of the following viruses, EXCEPT:
A) Epstein-Barr virus
B) cytomegalovirus
C) Herpesviruses
D) papilloma viruses
PBH-2.228.
The present-day AIDS epidemic originated in:
A) West Africa
B) North Africa
C) South Africa
D) Madagascar
PBH-2.229.
The diversity of the surface antigens of the HIV virus is caused by
frequent changes of the nucleotides in the:
A) env gene sequence
B) vif gene sequence
C) gag gene sequence
D) tat gene sequence
PBH-2.230.
Viral surface antigens are:
A) proteins
B) polysaccharides
C) lipopolysaccharides
D) glycoproteins
PBH-2.231.
The infectivity of the HIV virus decreases when a mutation occurs in the:
A) tat gene sequence
B) rev gene sequence
C) vif gene sequence
D) env gene sequence
PBH-2.232.
Necessary epidemiologic control measures in dipththeria include:
A) the occurrence of the infection as well as the recovery of the
patient should be reported; the regional public health authority
should be notified by telephone
B) hospital isolation of the patient is unnecessary
C) continuous and conclusive disinfection is unnecessary
D) the patient should be quarantined
PBH-2.233.
Human pathogens of tuberculosis include:
A) Mycobacterium tuberculosis hominis (in 99% of cases)
B) Mycobacterium tuberculosis bovis (in 3% of cases)
C) Mycobacterium tuberculosis hominis (in 97% of cases)
D) Mycobacterium brevis (in 3% of cases)
PBH-2.234.
The term "Pontiac fever" is:
A) the same as tuberculoid leprosy
B) the name of the mixed form of leprosy
C) used as a synonym for legionellosis
D) used as a synonym for lepromatous leprosy
PBH-2.235.
In chickenpox, the duties of the family practitioner include:
A) the occurrence of the infection should be reported
B) continuous and conclusive disinfection is unnecessary
C) the patient should be isolated from any children
D) all household member should receive antimicrobal
chemoprophylaxis
PBH-2.236.
A proper epidemiologic control measure for measles:
A) the occurrence of the infection should be reported to the local
infectious disease control centre
B) laboratory testing is not mandatory
C) continuous disinfection is unnecessary
D) isolation is unnecessary after clinical reovery
PBH-2.237.
A proper epidemiologic control measure for rubella:
A) isolation of the patient from pregnant women is unnecessary
B) continuous disinfection is unnecessary
C) laboratory testing is mandatory
D) rubella infections and any cases of the congenital rubella syndrome
should be reported
PBH-2.238.
Which of the following plays the most important role in warm weather?
A) the sympathetic vegetative system
B) the parasympathetic vegetative system
C) the appendages of the skin
D) the respiratory system
PBH-2.239.
Minamata disease is caused by:
A) alkyl mercury
B) beryllium
C) ethyl bromide
D) triethyl mercury
PBH-2.240.
The primary portal of entry for tricresyl-phosphate is the:
A) skin
B) mucous membranes
C) lung
D) secretory organs
PBH-2.241.
The prevalence of strongyloidosis in nurseries is as high as:
A) 10%
B) 80%
C) 5%
D) 27-68%
PBH-2.242.
The length of the incubation period of gonorrhoea is:
A) 2 days
B) 14 days
C) 3-7 days
D) several hours
PBH-2.243.
Epidemiologic features of scarlet fever include:
A) the contagiousness index is as high as 90%
B) the patient should be isolated
C) diagnostic laboratory testing is mandatory low as 1%
PBH-2.244.
Epidemiologic features of bacterial meningitis include:
A) an infectivity index as high as 100%
B) a contagiousness index as high as 50%
C) a contagiousness index as low as 0.1%
D) an infectivity index as low as 0.1%
PBH-2.245.
The principal contaminating substance in the water of wells in the
southern regions of Hungary is:
A) asbestos
B) arsenic
C) fluoride
D) nitrites
PBH-2.246.
Carcinogenicity as an iatrogenic effect is characteristic of.
A) cyclophosphamide
B) piroxicam (Hotemin)
C) rutoside (Venoruton)
D) acetylsalicylic acid (Kalmopyrin)
PBH-2.247.
An oncogenic substance is:
A) selenium
B) vinyl chloride
C) polyvinyl pyrrolidine
D) polyethylene
PBH-2.248.
Compared to non-smokers, smoking increases the risk of lung cancer by:
A) ten-fold
B) seventeen-fold
C) twenty-fold
D) five-fold
PBH-2.249.
Mortality due to malignancies is the highest in:
A) Uruguay
B) Scotland
C) Hungary
D) Belgium
PBH-2.250.
The trends of the cancer mortality curves of Austria and Hungary are:
A) similar
B) different as cancer mortality is increasing in Hungary and decreasing
in Austria
C) different as cancer mortality is increasing in Hungary and
stagnant in Austria
D) the same as cancer mortality is increasing in both countries
PBH-2.251.
How much do nutritional factors contribute to death caused by cancer?
A) 35-40%
B) 15%
C) 55%
D) 25%
PBH-2.252.
Provided that patient compliance is high, which of the following conditions
can be treated?
A) lung cancer
B) bronchial cancer
C) cancer of the colon
D) breast cancer
E) cervical cancer
PBH-2.253.
The NYVAC vector-virus is:
A) a variant of the vaccinia virus attenuated by deletion
B) a variant of the adenovirus attenuated by deletion
C) a vaccinia virus killed by b-propiolactone
D) a variant of the avipoxvirus that grows also in human cell cultures
PBH-2.254.
The principal portal of entry of cadmium is the:
A) skin
B) oral mucosa
C) lung
D) conjunctiva
PBH-2.255.
Indoor air-pollution is predominantly manifested by:
A) conjunctival irritation
B) numbness
C) cardiac pain
D) varicosity
PBH-2.256.
A relationship between water "hardness" and the risk of myocardial
infarction is:
A) nonexistent
B) positive
C) negative
D) only valid for the CaO content of the water
PBH-2.257
All of the following conditions can develop in Lyme-disease, EXCEPT:
A) the Bannawarth syndrome
B) chronic migratory erythema
C) arthritis
D) endarteritis
PBH-2.258.
Which of the following tests is performed to verify suspected
echinococcus infections?
A) Frankel's test
B) Casoni's intradermal test
C) Sabin-Feldman dye test
D) Wright's test
PBH-2.259
Which of the following water pollutants causes liver damage?
A) humic acid
B) asbestos
C) halothane
D) chloral hydroxide
PBH-2.260.
The extreme upper limit of "oxygen debt" is:
A) 100-200 litres
B) 30-40 litres
C) 16-18 litres
PBH-2.261.
The wavelength of infrared light ranges
A) from 300,000 to 500,000 nm
B) from 200 to 300 nm
C) from 750 to 300,000 nm
PBH-2.262.
The laser beam is most damaging to the:
A) skin
B) respiratory system
C) liver
D) eye
PBH-2.263.
What is electric ophthalmia?
A) the effect of strong electric shock on the unprotected eye
B) the effect of laser irradiation on the unprotected eye
C) the effect of exposure to UV-light on the unprotected eye
D) the effect of radiowaves on the unprotected eye
PBH-2.264.
Gray units (Gy) represent the:
A) absorbed dose
B) biological dose
C) dose performance
D) biological effectivity
PBH-2.265.
Which of the following radiation doses are considered particularly
important in public health?
A) exposure to a high dose on a single occasion
B) exposure to a low dose on a single occasion
C) serial exposure to low radiation doses
D) serial exposure to high radiation doses
PBH-2.266.
Lead inhibits the activity of all the following enzymes, EXCEPT:
A) d-aminolevulinate dehydratase
B) coproporphyrine decarboxylase
C) ferrochelatase
D) uroporphyrin dehydrogenase
PBH-2.267.
There is a relationship between all of the following paired statements,
EXCEPT:
A) the hardness of drinking water and coronary artery disease
B) methemoglobinemia and the nitrate content of drinking water
C) the nitrate content of drinking water and the morbidity of hypertension
D) the protozoa content of the drinking water and the occurrence
of some types of bowel cancer
PBH-2.268.
Valid statements regarding eutrophication include all of the following,
EXCEPT:
A) this phenomenon occurs in surface waters
B) this phenomenon occurs in overgrowth of algae
C) this phenomenon facilitates the growth of saprobes
D) the antonymous term is nontrophication
PBH-2.269.
All of the following are principal causes of indoor nosocomial infections,
EXCEPT:
A) mycobacteria
B) Escherichia coli
C) Staphylococcus aureus
D) Aspergillus flavus
PBH-2.270.
All of the following paired statements reflect a causal relationship,
EXCEPT:
A) asbestos - mesothelioma
B) 3,4-benzpyrene - bronchial carcinoma
C) benzene - leukemia
D) aniline - cancer of the urinary bladder
E) lead - central nervous system neoplasms
PBH-2.271.
Which of the following is a characteristic epidemiologic feature of
pertussis?
A) this pathogen produces endo- and exotoxins
B) infectivity is absent in the catarrhal stage of the disease
C) the contagiousness index is 60-80%
D) the infection is transmitted exclusively by droplets sprayed
F) pulmonary fibrosis
PBH-2.279.
All of the following are caused by carbon monoxide, EXCEPT:
A) extrapyramidal symptoms
B) CO aggravates the progression of atherosclerosis through cholesterol
C) cardiac repolarization disturbances
D) its affinity to hemoglobin is 300 times higher than that of oxygen
PBH-2.280.
All of the following are caused by sulphur dioxide, EXCEPT:
A) bronchospasm
B) mucosal irritation
C) conjunctival irritation
D) vagal paralysis
PBH-2.281.
All of the following are caused by nitrous oxide, EXCEPT:
A) conjunctival irritation
B) delirium
C) drowsiness
D) chronic exposure results in the develpoment of lung cancer
PBH-2.285.
Compared to those living in detached houses, children living in
apartments:
1) are less well-developed
2) have more unstable vegetative functions
3) have higher blood pressures
4) are more even-tempered
PBH-2.286.
Which of the following is not an anthropozoonosis?
1) Q fever
2) hymenolepidosis
3) Marburg disease
4) Necator americanus infestation
PBH-2.287.
Which of the following substances has been involved in the water
pollution at Vac in Hungary?
1) cyclohexanon
2) palmitate
3) toluol nitril
4) beryllium
PBH-2.288.
Air pollution increases the incidence of:
1) lung neoplasms
2) conjunctivitis
3) emphysema
4) sinusitis
PBH-2.289.
Environmental noise is an etiologic factor in the development of
1) neurosis
2) hypertension
3) hearing loss
4) Raynaud's syndrome
PBH-2.290.
Exposure to environmental noise may cause:
1) Reye's syndrome
2) an increased excretion of vanillylmandelic acid
3) neurasthenia
4) Cannon's stress-reaction
PBH-2.291.
The effects of alcohol:
1) facilitate the development of neoplasms
2) are mitogenic
3) are antimitogenic
4) are synergistic with those of endogenous nitrous oxide
PBH-2.292.
Alcohol:
1) binds to opiate receptors
2) is a vasodilator and reduces the morbidity due to myocardial
infarction
PBH-2.342.
The incidence of liver cirrhosis is increasing progressively in Hungary
because the alcohol consumption of the Hungarian population
is the highest in the world.
PBH-2.343.
The incidence of liver cirrhosis is increasing progressively in Hungary
because the Hungarian population consumes the largest volume
of ardent spirits in the world.
PBH-2.344.
Olive oil is an essential component of Hungarian cuisine because
animal fat is less healthy.
PBH-2.345.
w-3-fatty acids have a protective effect against malignant diase because
these substances only inhibit the interactions of oncogenes.
PBH-2.346.
The w-3-fatty acid content is the highest in seafood because their
palmitate component is a characteristic substance in the liver of marine
animals.
PBH-2.347.
Linolenic acid has a protective effect against malignant disease because
it contains a -3-fraction.
PBH-2.348.
Linolenic acid promotes the development of neoplasms because it is
an unsaturated fatty acid.
PBH-2.349.
Linolenic acid promotes the development of neoplasms because it
interacts with oncogenes.
PBH-2.350.
Linolenic acid inhibits carcinogenesis because it is an unsaturated
fatty acid.
PBH-2.351.
Linolenic acid promotes the development of malabsorption syndromes
because it is an unsaturated fatty acid.
PBH-2.352.
The incidence of cervical carcinoma is decreasing in Hungary because
the success rate of cervical carcinoma therapy is high.
PBH-2.353.
Smokers are better protected against the development of Alzheimer's
disease than non-smokers because the influence of nicotine on
dopamine metabolism is highly preventive.
PBH-2.354.
The incidence of cervical carcinoma is decreasing in Hungary because
there are successful screening programs under way.
PBH-2.355.
The prevalence of cervicRal carcinoma is increasing in Hungary because
there are successful screening programs under way.
PBH-2.356.
The mortality of cervical carcinoma is increasing in Hungary because
there are successful screening programs under way.
PBH-2.357.
The mortality of cervical carcinoma is decreasing in Hungary because
there are successful screening programs under way.
PBH-2.358.
The mortality of gastric carcinoma is decreasing in Hungary because
there have been successful nutritional campaigns in Hungary.
PBH-2.359.
The incidence of gastric carcinoma is decreasing in Hungary because
educational programs on healthy nutrition have been highly successful.
PBH-2.360.
The incidence of gastric carcinoma is decreasing in Hungary because
the screening activity of gastrofiberoscopy centres is effective.
PBH-2.361.
The mortality of gastric carcinoma is decreasing in Hungary because
there are successful screening programs under way.
PBH-2.362.
The mortality of gastric carcinoma is decreasing in Hungary because
certain dietary habits have changed favourably.
PBH-2.363.
In Hungary, the mortality of bronchial carcinoma increases more progressively
than in similarly developed countries because environmental
pollution is higher in Hungary than in other East-European countries.
PBH-2.364.
In Hungary, the mortality of oral, laryngeal and pharyngeal carcinoma
increases progressively because Hungarian smoking habits are different
from those prevailing in other similarly developed countries.
PBH-2.365.
The incidence of cervical carcinoma is significantly higher in nuns
than in promiscuous women because sexual abstinence reduces the
incidence of cervical cancer.
PBH-2.366.
The incidence of cervical carcinoma is significantly lower in nuns
than in promiscuous women because sexual abstinence reduces the
incidence of cervical cancer.
PBH-2.367.
The incidence of cervical carcinoma is significantly lower in Muslim/
Jewish women than in Christians because the copulation habits are
PBH-2.379.
Morbidity due to myocardial infarction is lower in populations consuming
hard drinking water because hard water has a protective
effect against myocardial infarction.
PBH-2.380.
Polycyclic hydrocarbon constituents of tobacco smoke are pluripotent carcinogens
because these substances form adducts in the blood.
PBH-2.381.
The exhaust fumes of two-stroke engines may contain polycyclic hydrocarbons
because these substances are formed during incomplete combustion.
PBH-2.382.
Polycyclic hydrocarbons cause neoplasms predominantly in the respiratory
system because the concentration of these substances is
extremely high in polluted air.
PBH-2.383.
The main component of the London-type smog is carbon monoxide
because PAN substances are formed in photochemical reactions.
PBH-2.384.
The main components of the Los Angeles-type smog are PAN substances
because PAN substances are formed in photochemical reactions.
PBH-2.385.
Air pollution has dramatic effects on human health because its influence
is more significant than that of soil contamination.
PBH-2.386.
Drinking water influences human health because carcinogenic substances
can be formed as an adverse effect of chlorination.
PBH-2.387.
Hemangiosarcoma may develop in employees of polyvinyl chloride
producing factories because several derivatives of polyvinyl chloride
have hepatocyte-specific effects.
PBH-2.388.
Exposure to asbestos causes mesothelioma because asbestos fibers
are epigenetic carcinogens.
PBH-2.389.
Exposure to asbestos causes mesothehoma and bronchial carcinoma
because asbestos is a genotoxic carcinogen.
PBH-2.390.
Promoters exert their influence in the second phase of
carcinogenesis because these factors are genotoxic.
PBH-2.391.
Promoters exert their influence in the second phase of
carcinogenesis because these are membrane-active factors.
PBH-2.392.
PBH-2.464.
Blood products are potential sources of the HIV virus because blood
broducts are still not screened for HIV positivity in Hungary.
PBH-2.465.
Blood products are important sources of HIV infection because several
thousand patients have contracted AIDS by the administration
of HIV positive blood products in Romania.
PBH-2.466.
The condom provides efficient protection against HIV infection because
anal intercourse is only possible with a condom.
PBH-2.467.
Excoriations of the anal mucosa are convenient portals of entry for
the HIV virus because the HIV infection spreads only by mucosal
infection.
PBH-2.468.
The prevalence of blood-borne HIV infections is increasing in Hungary
because the efficacy of HIV testing of blood products has decreased.
PBH-2.469.
The number of patients with AIDS has decreased in Hungary because
HIV testing is rigorously performed on donated blood.
PBH-2.470.
The incidence of AIDS is stagnant in Hungary because Hungary is
the centre of the Middle-European condom industry.
PBH-2.471.
The Bill of Human Rights authorizes the HIV positive individual to
disclose the identitiy of his/her sexual partners because the identification
of sexual partners is mandatory in Hungary.
PBH-2.472.
It is difficult to track down HIV positive individuals in Hungary because
the disclosure of the identity of sexual partners would breach
the provisions of the Bill of Human Rights.
PBH-2.473.
The Sabin-Feldman test is a specific method for the diagnosis of
toxoplasmosis because the Sabin-Feldman test is a specific immunologic
reaction.
PBH-2.474.
Darkfield microscopy is used in the diagnostics of syphilis because
darkfield microscopy is a specific method for the detection of the
pathogen of syphilis.
PBH-2.475.
Leptospirosis is endemic in Hungary because recreational exposure (i.e.
swimming in contaminated waters) is prevalent in rural populations.
PBH-2.476.
The livestock of Hungarian agriculture is infected with brucellosis
PBH-2.490.
Cobalt is a component of vitamin B12 because cobalamin binds cobalt
in the liver by acidic linking.
PBH-2.491.
-carotenes inhibit the formation of neoplasms because -carotenes
have antioxidant properties.
PBH-2.492.
Herbal glycosides are important in the prevention of malignancy because
these substances inhibit the activity of the protein kinase C enzyme.
PBH-2.493.
Mller-Barlow disease is an adult type of vitamin C deficiency because
the deficiency of vitamin C may result in the development of scurvy.
PBH-2.494.
The consumption of roast meat is unhealthy because barbecuing
induces the formation of nitrosamines in meat.
PBH-2.495.
The consumption of barbecued meat is unhealthy because barbecuing
induces the formation of nitrosamines in meat.
PBH-2.496.
The consumption of meat roasted on charcoal embers can be
unhealty because this may result in the formation of -carotenes.
PBH-2.497.
The consumption of stewed meat can be considered healthy because
stewing does not induce the formation of polycyclic carbohydrogens.
PBH-2.498.
Pork is healthier food than poultry because it contains less tryptophan.
PBH-2.499.
Poultry contains more tryptophan than pork therefore, poultry is
healthier than pork.
PBH-2.500.
The consumption of vegetables is healthy because green vegetables
accumulate benzpyrene from the atmosphere.
PBH-2.501.
The consumption of fish is deleterious to health because water pollutants
may accumulate in the fish liver.
PBH-2.502.
Cytochrome P450 is an enzyme involved in the detoxification functions
of the liver therefore the activation of cytochrome P450 is deleterious
to health.
PBH-2.503.
Cytochrome P450 is an enzyme involved in the inactivation of health
damaging substances therefore factors activating cytochrome P450
PBH-2.517.
All unsaturated fatty acids have a protective effect against cancer
because all of them contain linolenic acid.
PBH-2.518.
The Declaration of the World Conference held in 1980 in Almaty is of
extreme significance because it declares primary health care as the
primary instrument for implementig the objectives of "Health for all
by the year 2000" incentive.
PBH-2.519.
The Ottawa Charter is a particularly important document of the "Health
for all by the year 2000" movement because it gives the definition of
health promotion as well as the methods of its implementation.
PBH-2.520.
Intersectorial co-operation is an important method in the fulfillment
of the objectives set by WHO because it facilitates the enhanced cooperation
of different disciplines.
PBH-2.521.
The suicide statistics of different countries are readily comparable because
the system of data collection and processing is totally uniform.
PBH-2.522.
Hungary is ranked the world leader as far as mortality due to suicide
is concerned because mortality due to suicide in Hungary is higher
than 25/ 100,000.
PBH-2.523.
More females die from cardiovascular disease than males because
the cardiovascular mortality of males under the age of 60-64 years is
twice that of females.
PBH-2.524.
The incidence of myocardial infarction (AMI) is increasing in progressively
younger age-groups because in 1989 the incidence of AMI
in males aged 40-44 was the same as the corresponding incidence in
the 45-49 age group in 1988.
PBH-2.525.
Different disease models describe different levels of pathologic processes
therefore, the prevention of the development of pathologic
processes is the main objective of health development.
PBH-2.526.
Alcohol consumption interferes with driving because alcohol reduces
coordination and prolongs reaction time.
PBH-2.527.
The evaluation of the psychosocial aspects of a disease is an insignificant
component of the life course study because the necessary
interventions implied by the results are non-medical.
PBH-2.528.
Maintaining good relations with self-help movements and self-care
B) IHD mortality
C) Mortality due to myocardial infarction
D) Stroke mortality
E) None of the above
1) it is responsible for about 53% of overall mortality
2) it is responsible for 30% of overall mortality
3) its prevalence has increased by 40% over the last 30 years
4) more than the half of this is comprised by death due to
myocardial infarction
5) the mortality rate of females is almost twice as high as that of
males
6) the mortality rate of males is almost twice as high as that of
females
7) the mortality due to this condition is higher than the average
in rural populations
8) the mortality due to this condition has decreased by one-half
9) its lethality is almost 40%
PBH-2.541.
Associate the following term(s) with their corresponding statement(s)!
A) Mechanical biological concept
B) Functional physiological concept
C) Corticovisceral pathology
D) Psychosomatic concept
1) the environment in its completeness is manifested by the complexity
of social conditions
2) concentrates on the method of processing social effects
3) regards both health and disease as purely biological phenomena
4) its essential principle is the regulative coordination of functions;
disordered coordination results in the development of lesions
PBH-2.542.
Associate the following term(s) with their corresponding statement(s)!
A) Almaty Declaration
B) Ottawa Charter
C) Madrid Target Document
1) it defines the concept of health promotion
2) it declares health as the inherent right of all human beings
3) it challenges prevailing inequity regarding health and illness
4) it endeavors to incite people to assume responsibility for their
health
5) it formulates concrete objectives for the European region
6) it is the first to declare primary health care as the essential
principle of health delivery ,
PBH-2.543.
Associate the following term(s) with their corresponding statement(s)!
A) Intersectorial co-operation
B) Primary health care
C) Uniform public policy
D) None of the above
1) it is the core principle of the restructuring of health care
89.A
90.C
91.C
92.C
93.C
94.D
95.C
96.B
97.C
98.B
99.C
100.D
101.C
102.E
103.D
104.B
105.B
106.C
177.C
178.A
179.D
180.D
181.I
182.C
183.D
184.D
185.A
186.C
187.A
188.B
189.B
190.B
191.A
192.C
193.D
194.D
265.C
266.D
267.D
268.D
269.B
270.E
272.B
272.D
273.C
274.B
275.B
276.B
277.D
278.F
279.C
280.D
281.D
282.E
353.C
354.B
355.D
356.D
357.A
358.A
359.A
360.C
361.C
362.A
363.C
364.C
365.E
366.C
367.C
368.E
369.A
370.A
441.A
442.B
443.B
444.C
445.C
446.D
447.C
448.A
449.C
450.C
451.D
452.B
453.A
454.B
455.C
456.A
457.B
458.C
529.D
530.A
531.E
532.A
533.A
534.D
535.D
536.DBAEC
537.CABBACAB
538.DBACE
539.EDCAB
540.AEABDCDEC
541.CDAB
542.BAABCA
543.BDDAC
544.BBAAAC
545.DAABCCC
546.BABAA
19.D
20.D
21.A
22.B
23.E
24.D
25.A
26.B
27.C
28.C
29.C
30.C
31.C
32.D
33.B
34.D
35.D
36.B
37.A
38.A
39.C
40.B
41.D
42.C
43.B
44.D
45.C
46.B
47.C
48.E
49.B
50.C
51.A
52.C
53.B
54.B
55.B
56.C
57.D
58.D
59.A
60.A
61.C
62.B
63.E
64.D
65.D
66.A
67.A
107.D
108.D
109.B
110.C
111.C
112.D
113.B
114.B
115.A
116.C
117.D
118.A
119.A
120.C
121.B
122.C
123.B
124.G
125.D
126.B
127.C
128.C
129.B
130.A
131.D
132.C
133.D
134.C
135.C
136.A
137.A
138.C
139.B
140.B
141.D
142.B
143.D
144.D
145.B
146.B
147.C
148.C
149.D
150.A
151.D
152.C
153.A
154.C
155.B
195.C
196.C
197.C
198.C
199.A
200.C
201.C
202.B
203.D
204.B
205.D
206.B
207.C
208.D
209.D
210.C
211.A
212.C
213.A
214.C
215.D
216.A
217.C
218.C
219.C
220.D
221.C
222.D
223.D
224.D
225.C
226.C
227.D
228.B
229.A
230.D
231.C
232.A
233.A
234.C
235.C
236.B
237.D
238.A
239.A
240.A
241.D
242.C
243.B
283.A
284.C
285.A
286.C
287.A
288.E
289.A
290.C
291.B
292.C
293.B
294.C
295.E
296.B
297.A
298.A
299.A
300.D
301.D
302.A
303.A
304.E
305.A
306.C
307.E
308.A
309.B
310.A
311.A
312.B
313.C
314.C
315.D
316.D
317.C
318.C
319.B
320.E
321.C
322.E
323.D
324.D
325.B
326.D
327.C
328.A
329.E
330.D
331.B
371.A
372.A
373.A
374.B
375.A
376.A
377.E
378.C
379.D
380.B
381.A
382.B
383.A
384.B
385.B
386.B
387.A
388.B
389.C
390.C
391.B
392.B
393.A
394.B
395.C
396.C
397.B
398.A
399.A
400.D
401.C
402.B
403.A
404.A
405.A
406.A
407.B
408.D
409.C
410.A
411.B
412.A
413.A
414.B
415.B
416.B
417.C
418.E
419.E
459.E
460.E
461.A
462.A
463.D
464.C
465.B
466.C
467.C
468.E
469.D
470.E
471.E
472.A
473.C
474.C
475.D
476.E
477.E
478.A
479.C
480.E
481.C
482.C
483.E
484.E
485.D
486.E
487.D
488.E
489.A
490.C
491.A
492.C
493.D
494.C
495.C
496.C
497.A
498.C
499.D
500.B
501.D
502.C
503.A
504.B
505.C
506.E
507.B
547.BADC
548.AABBA
549.BAABB
68.D
69.B
70.B
71.A
72.A
73.B
74.C
75.C
76.C
77.D
78.E
79.B
80.D
81.B
82.D
83.B
84.D
85.B
86.D
87.A
88.B
156.C
157.B
158.D
159.C
160.D
161.C
162B
163.B
164.C
165.C
166.D
167.B
168.C
169.B
170.D
171.C
172.B
173.B
174.B
175.A
176.A
244.C
245.B
246.A
247.B
248.B
249.C
250.B
251.A
252.E
253.A
254.C
255.C
256.B
257.D
258.B
259.C
260.C
261.C
262.D
263.C
264.A
332.D
333.E
334.C
335.B
336.C
337.C
338.E
339.E
340.C
341.C
342.C
343.A
344.D
345.C
346.C
347.E
348.B
349.E
350.B
351.D
352.D
420.B
421.C
422.C
423.B
424.B
425.A
426.C
427.C
428.C
429.C
430.C
431.C
432.A
433.B
434.A
435.A
436.A
437.A
438.C
439.A
440.A
508.C
509.C
510.C
511.B
512.A
513.D
514.C
515.A
516.C
517.D
518.D
519.A
520.C
521.E
522.C
523.B
524.B
525.C
526.A
527.E
528.A
PSYCHIATRY (PSY-3)
TRUE-FALSE TYPE QUESTIONS
Put T for true statements and F for false statements!!!
PSY-3.1.
During family therapy, a more advisable approach is to tell each
family member that they can change for the better, rather than to
stigmatize them.
PSY-3.2.
In order to be more effective with a particular course of therapy, it is
advisable not to have any preconceptions that can govern our therapeutic
attempts.
PSY-3.3.
It is advisable to avoid taking the parent's role when consulting
children who are neglecting their duties.
PSY-3.4.
In a partially separated family with children who areneglecting their
duties, there is still a risk for strong loyalties among the divided
family members.
PSY-3.5.
It is advisable to stay neutral rather than to becomeauthorative over
the family during family psychotherapy.
D) identification
PSY-3.22.
Thumb sucking:
A) usually ceases by the first year of age
B) may normally be observed during sleep until the age of 3
C) is physiologically present during the first few months of life
D) is observed in 20% of children above the age of 6
E) all of the above
PSY-3.23.
The proportion of suicides which have already been preceded by
earlier suicie attempts is:
A) 10%
B) 20%
C) 50%
D) 60%
E) 100%
PSY-3.24.
The most common form of a learning disorder is:
A) difficulty in spelling words
B) difficulty in arithmetic tasks
C) a writing disorder
D) a reading disorder
E) none of the above
PSY-3.25.
Contraindications to lithium administration include:
A) an administration in combination with chlorpromazine
(Thorazine)
B) the presence of a renal disease
C) any occurrence of the symptoms of schizophrenia
D) the presence of depression
E) an administration in combination with imipramine (Tofranil)
PSY-3.26
"Suggestion" as a form of a psychotherapy is used in:
A) conversion disorder
B) child psychiatry
C) patients with a low IQ
D) all of the above
E) none of the above
PSY-3.27.
Perception without corresponding environmental stimuli is:
A) a hallucination
B) an illusion
C) a delusion
D) derealization
E) depersonalization
PSY-3.28.
The occurrence of which of the following symptoms would allow
differentiation between delirium and dementia?
A) an impaired judgment
B) a memory deficit
C) an impaired consciousness
D) an impaired process of thinking
E) disorientation
PSY-3.29
A loss of remote memory is a typical symptom of delirium tremens
A) delirium tremens
B) senile dementia
C) schizophrenia
D) Korsakoffs syndrome
E) hysteria
PSY-3.30
Disorders characterized by delusions include all of the following, EXCEPT:
A) affective disorders
B) organic mental disorders
C) paranoid disorders
D) personality disorders
E) schizophrenic disorders
PSY-3.31.
Early in the psychiatric interview, it is important for the physician to;
A) inform the patient of the fee
B) obtain details of any past psychiatric illnesses
C) let patients talk about what is bothering them
D) obtain information about the patient's mood
E) record the family history
PSY-3.32.
A typical exhibitionist:
A) projects repressed homosexual impulses
B) is impotent
C) experiences loneliness and shame
D) is older than 50
E) is schizophrenic
PSY-3.33
Factors determining an adult's gender identity include:
A) parental attitudes about the patient's sex during childhood
B) the availability of sexual partners
C) endocrine factors
D) the external genitals
E) the sex chromosomes
PSY-3.34.
Which of the following symptoms is least characteristic for schizophrenia?
A) autistic thinking
B) bizarre delusions
C) hypnagogic hallucinations
D) neologisms
E) thought blocking
PSY-3.35.
Physical processes involved in the development of the "superego"
include all of the following EXCEPT:
A) identification
B) internalization
C) introjection
D) isolation
E) idealization
PSY-3.36.
A "projection" mechanism is most characteristic for which of the
following personality disorders?
A) an anancastic personality
B) a schizoid personality
C) a hypomanic personality
D) a paranoid personality
E) an antisocial personality
PSY-3.37
Procrastination, scorning the efforts of others, forgetting appointments,
duties and obligations are all examples of:
A) splitting
B) projection
C) regression
D) acting out
E) passive aggression
PSY-3.38.
Anxiety is a common symptom of all the following conditions, EXCEPT.
A) hypoglycemia
B) hypothyroidism
C) pheochromocytoma
D) porphyria
E) hypocalcemia
PSY-3.39.
The mortality rate of anorexia nervosa is:
A) less than 1%
B) 5-15%
C) 20-30%
D) 35%
E) 50%
PSY-3.40
A "borderline personality disorder" is characterized by all of the
following symptoms, EXCEPT:
A) impulsivity and an unpredictable behavior
B) identity disturbances
C) mood instability
D) withdrawal from social activity
E) recurrent suicidal gestures and short psychotic episodes
PSY-3.42.
Case Study:
A 56-year-old male presents with symptoms of irritability and disinterest
in his daily activities. At times, he is confused and forgetful.
His gait is unsteady. The deep tendon reflexes are diminished.
He frequently experiences tingling in his legs. The most likely diagnosis
is:
A) hypothyroidism
B) a cerebellar tumor
C) multiple sclerosis
D) a vitamin B12 deficiency
E) presenile dementia
PSY-3.43.
Bleuler's symptoms of schizophrenia (the four A's) include all of the
following EXCEPT:
A) ambivalence
B) affective flattening
C) apathy
D) autism
E) loose associations
PSY-3.44.
Case Study:
A 25-year-old patient complains of hearing voices speaking about
him and threatening him. The patient regards them as real and
suffers from them. The most likely diagnosis is:
A) schizophrenia
B) alcoholic hallucinations
C) dementia
D) hysteria
E) debility
PSY-3.46.
Personality disorders are almost always:
A) manifested during adolescence
B) worse in old age
C) free of genetic-biologic influences
D) associated with good occupational functioning
E) seen intermittently during adult life
PSY-3.47
Case Study:
A 23-year-old woman complains of becoming occasionally anxious.
These occurences are associated with tachycardia and excessive sweating.
The condition usually develops in the morning. Which of the following
tests has to be performed urgently?
A) thyroid function tests
B) toxicological screening
C) determination of the serum sodium level
D) determination of the blood glucose level
E) determination of the serum ammonia level
PSY-3.49.
Patients suffering from which of the following disorders are most
likely to be concerned with their diseases?
A) hypochondriasis
B) the different phobias
C) conversion neurosis
D) somatization syndrome (Briquet's syndrome)
E) aggravation
PSY-3.51.
Case Study:
A middle-aged waiter was admitted to the psychiatric ward in a drunken
state. While in the ward his behavior became bizarre and he gradually became
became disoriented to place and time. He sometimes acted as if he was
taking orders or serving dishes. On examination he usually
misinterpretated the antecendents and circumstances of his admission. He was unable to
recall his answers to simple questions after a few minutes. He denies any
hallucinations or delusions. The patient has had no prior psychiatric
disorders. His relatives haven't found anything extraordinary about his behavior.
The most likely diagnosis is:
A) alcohol withdrawal syndrome (delirium tremens)
B) acute paranoid schizophrenia
C) alcoholic hallucinations
D) alcohol amnestic syndrome (Korsakof's syndrome)
E) manic phase (of bipolar disorder)
PSY-3.53
The clinical course of affective disorders is characterized by:
A) cyclic relapsing episodes
B) a slow progression
C) a slow progression occasionally interrupted by periods of acute
relapses
D) acute relapses
E) dementia
PSY-3.54.
The psychotherapy of schizophrenic patients includes all of the
following, EXCEPT:
A) a warm, open relationship aiming to promote the patient's selfesteem
and educating the patient about his/her disease
B) a supportive psychotherapy that focuses on resolving the
problems of the patient in his/her everyday life
C) setting limits on the patient's behavior, including the consequences
of his/her violent actions
D) encouraging socialization in order to build more extensive
social relationships
E) encouraging the patient to express his/her anger and hostility as
much as possible in the therapeutic relationship in order to reduce
the intensity of these emotions outside the consulting office
PSY-3.55.
Neurotransmitters believed to have a role in the pathophysiology of
schizophrenia include all of the following EXCEPT:
A) dopamine
B) prostaglandin El
C) ascorbic acid
D) norepinephrine
E) serotonin
PSY-3.56.
According to the DSM-III-R, the principal diagnostic difference
between schizophrenia and a schizophreniform disorder is:
A) the time of onset of the psychotic symptoms
B) the duration of the disorder
PSY-3.68.
Case Study:
A young man develops an irrepressible urge to wash his hair several times
a day which he explains as a means of protection against infection from
others. He assures everyone that he feels well but he becomes extremely
anxious if he cannot wash his hair. The most probable diagnosis is:
A) automatism
B) compulsive personality disorder
C) hypochondriasis
D) compulsive thoughts
E) phobia
PSY-3.69.
Unconscious emotions generated by a physician during psychotherapy
are best described by the term:
A) projection
B) impulse transmission
C) acting out
D) identification
E) introjection
PSY-3.70.
Case Study:
A 25-year-old woman who has extramarital affairs fears that her
physician disapproves strongly of her behavior. This represents
which of the following defense mechanisms?
A) denial
B) repression
C) reaction formation
D) isolation
E) projection
PSY-3.71.
Which of the conditions listed below is most commonly associated
with a violent behavior?
A) an XYY chromosome anomaly
B) a low level of intelligence
C) an XO chromosome anomaly
D) epilepsy
E) none of the above
PSY-3.72.
Case Study:
A 15-year-old girl presents to the emergency room with severe
weight loss. On examination she is cachectic, bradycardic, and
hypotensive. The first course of action should be to:
A) determine the family dynamics
B) administer a high-protein and carbohydrate diet
C) draw blood for a serum electrolyte determination and then
start intravenous feeding
D) arrange to have the patient admitted to the psychiatric ward
E) prepare for electroconvulsive therapy
PSY-3.73.
Based on the results of psychiatric epidemiological studies, the most
common psychiatric disorder among the general population is:
A) depression
B) schizophrenia
C) alcoholism
D) phobias
E) dementia
PSY-3.74.
The ratio of psychiatric disturbances among patients who seek
evaluation for somatic diseases is:
A) 10%
B) 20%
C) 33%
D) 50%
E) 90%
PSY-3.75.
Case Study:
A 21-year-old woman who presents with depressive symptoms in
December reports a similar episode during late autumn. The most
likely mechanism of her depression involves:
A) noradrenergic hyperactivity
B) diminished serotoninergic activity
C) alterations in the diurnal rhythm
D) the deterioration of family relationships
E) none of the above
PSY-3.76.
Case Study:
A 40-year-old woman developed delusions during the past year that
her husband was having an affair with her sister. She denies any hallucinations.
Her emotions and her behavior correspond to the contents
of the delusion. The most likely diagnosis is:
A) acute paranoid disorder
B) polie a deux (induced mental disorder)
C) paranoia
D) paranoid schizophrenia
E) schizophreniform disorder with a paranoid character
PSY-3.77.
Statements characteristic for the epidemiology of mood disorders
include all of the following, EXCEPT:
A) the lifelong risk for bipolar disorders is 1%
B) depression may be manifested at any age
C) dysthymia (neurotic depression) is commonly associated with
organic and psychiatric disorders
D) depression is more frequently diagnosed in men than in women
E) the risk for a major mood disorder is higher among family
members of a diseased individual than among the general
population
PSY-3.78.
Case Study:
A 20-year-old man is admitted to the hospital. He developed hallucinations
and delusions of persecution three weeks ago. He is currently agitated.
Possible diagnoses, based on the DSM-III-R, include all of the following,
EXCEPT:
following, EXCEPT:
A) diazepam (Seduxen)
B) phenobarbital (Sevenal)
C) disulfiram (Anticol, Antaethyl)
D) glutethimide (Noxyron)
E) haloperidol
PSY-3.85.
Common complications of alcoholism include:
A) cerebral damage
B) gastritis
C) suicide
D) polyneuropathy
E) all of the above
PSY-3.86.
Alzheimer's disease can be diagnosed by which of the following methods?
A) computerized tomography
B) EEG
C) laboratory tests
D) lumbar puncture
E) clinical judgement
PSY-3.87.
Organic mental syndromes include all of the following, EXCEPT:
A) delirium
B) dementia
C) amnestic syndromes
D) paranoid disorders
E) organic hallucinosis
PSY-3.88.
Diseases that lead to mental retardation and require genetic counselling
include all of the following, EXCEPT:
A) Tay-Sachs disease
B) galactosemia
C) phenylketonuria
D) Down's syndrome
E) cerebral paralysis (Little's disease)
PSY-3.89.
The aim of methadone maintenance during the treatment of addiction is:
A) to detoxify the patient and then gradually withdraw the opiates
B) to treat the underlying psychological causes
C) to satisfy the "drug-hunger" of the addict in order to make it
possible for him to deal with other aspects of his life
D) to use methadone as an opiate antagonist
E) to teach the addict about the dangers of narcotics
MULTIPLE CHOICE QUESTIONS WITH KEY ANSWERS / TYPE II
Every question or incomplete statement has only one answer in the
following combinations:
A) if the answers 1, 2, and 3 are true
B) if the answers 1 and 3 are true
C) if the answers 2 and 4 are true
D) if only the answer 4 is true
Case Study:
A 62-year-old man seeks evaluation for weakness, a loss of initiative,
a loss of weight, and abdominal discomfort. He appears to be
depressed. Possible diagnoses can include:
1) dementia
2) pain killer abuse
3) pancreatic carcinoma
4) hyperthyroidism
PSY-3.107.
Case Study:
A 36-year-old man is brought to the emergency room by the police. He
has been caught speeding on the highway at night without his headlights
on. On examination he is agitated and belligerent. He warned
the physician and the policemen that he has "friends" in high places
whom he is currently in contact with and that the policemen who have
incarcerated him will be punished. Diagnostic possibilities can include:
1) hyperthyroidism
2) arsenic intoxication
3) amphetamine overdose
4) Addison's disease
PSY-3.108.
Cocaine addiction may be manifested as:
1) a sexual dysfunction in males
2) an increased need for sleep
3) severe anxiety and paranoid delusions
4) hallucinations
PSY-3.109.
Case Study:
A 67-year-old man is brought to the emergency room by the police for
exposing himself in the nude to schoolchildren. There is no history of
similar events in the past. Possible causes of this behavior include:
1) a petit mal seizure
2) Alzheimer's disease
3) digitalis intoxication
4) an intracranial tumor
PSY-3.110.
The usual causes of an inhibited female orgasm include:
1) a lack of information
2) major psychopathology
3) trauma from the first relationship
4) the sedative side-effects of medications
PSY-3.111.
Which of the following agents have an important role in the therapy
of alcohol withdrawal delirium?
1) meprobamate and benzodiazepines
2) vitamin B complex
3) chlormethiazole (Heminevrin)
4) potassium and magnesium ions
PSY-3.112.
Patients suffering from a personality disorder:
1) may occasionally lose touch with reality
include:
1) tachycardia
2) constipation
3) the retention of urine
4) blurred vision
PSY-3.137
Case Study:
A 53-year-old woman underwent an operation for a fracture of the
neck of the femur. On the second postoperative day she became agitated
and incooperative. On the third day she was noted to have hallucinations
and addressed the nurses by the names of her own children.
Possible causes of her symptoms include:
1) alcohol withdrawal
2) intravenously administered penicillin
3) sepsis
4) general anesthesia
PSY-3.138:
A patient with a major depression is likely to exhibit which of the
following symptoms?
1) negligence
2) agitation and anxiety
3) defensiveness
4) sadness
PSY-3.139
Tricyclic antidepressants and MAO inhibitors are effective for the
treatment of
1) bulimia
2) compulsive personality disorder
3) anancastic disorder
4) atypical depression
PSY-3.140
The most characteristic symptoms of delirium tremens include:
1) tremor
2) sweating
3) blackouts
4) hallucinations
PSY-3.141.
Dysthymia is characterized by:
1) chronic fatigue
2) social withdrawal
3) insomnia
4) hypersomnia
PSY-3.142.
The DST (dexamethasone-suppression test) has limited usefulness
in the diagnosis of depression because:
1) the patient is noncompliant
2) the plasma control levels are subject to diurnal variation
3) the test is too expensive for routine clinical use
4) many medical conditions give false positive results
PSY-3.143.
Case Study:
A 22-year-old artist, a few days after the death of his father from
suicide, becomes euphoric and highly concerned about how he looks. He is
hyperactive, restless, and has no insight into his condition. He says that
he is extremely happy. Which of the following should be considered?
1) personality disorder
2) narcomania
3) a primitive reaction
4) manic or hypomanic syndrome
PSY-3.144.
Common complications of alcoholism include:
1) cerebral damage
2) gastritis
3) hypertension
4) suicide
PSY-3.145.
Drugs that can cause dependence include:
1) benzodiazepines
2) antihistamines
3) barbiturates
4) tricyclic and tetracyclic antidepressants
PSY-3.146.
Which of the sexual disorders listed below are characterized by the
statement that psychologically immature young males are usually aggressive
to their "victims" in order to obtain sexual gratification?
1) transsexualism
2) homosexuality
3) erection disorder
4) exhibitionism
SINGLE CHOICE QUESTIONS
Select the single best response to each of the following questions!!!
PSY-3.147.
The most typical example of a simple phobia is a fear of:
A) heights
B) public transportation
C) dogs
D) being in crowds
E) social situations
PSY-3.148.
Case Study:
A 22-year-old patient, during an interview, recalled that she had seen
two doves sitting on the window sill, which she recognized as a future
sign of an important event that would take place in her life in two
weeks time. This symptom should be regarded as a(n):
A) illusion
B) hallucination
C) delusion
D) neologism
E) incoherence
PSY-3.149
The most important process in the development of the ego is:
A) identification
B) projection
C) reaction formation
D) regression
E) repression
PSY-3.150.
Emotional reactions towards the physician, which reflect recent
experiences and relationships outside of the therapeutic setting, may be
defined as:
A) acting out
B) fixation
C) free associations
D) impulse transmission
E) anxiety
PSY-3.151.
Case Study:
A middle-aged woman is brought to the intensive care unit complaining
of thoracic pain. Despite the appropriate diagnosis and therapy
the woman died soon after. The husband begins to threatens the physician
that he will sue him. This behavior is an example of which of the
following defense mechanisms?
A) shifting
B) dissociation
C) overcompensation
D) reaction formation
E) regression
PSY-3.152.
Which of the following abnormalities is most characteristic for psychosis?
A) an abnormality of the thought process
B) schizophrenia
C) manic-depressive psychosis
D) reality testing is impaired
E) impulsiveness and illogical behavior
PSY-3.153.
A characteristic defense mechanism involved in paranoid symptom
formation is:
A) reality denial
B) conversion
C) projection
D) isolation
E) acting out
PSY-3.154.
Case Study:
An elderly, mildly confused man is brought to the emergency room by
his son. When asked about his problems the patient mentions "abnormalities
of function". His answer to the next question is the same. This
is an example of:
A) coprolalia
B) coprophobia
C) fixation
D) perseveration
E) echolalia
PSY-3.155.
Case Study
A 29-year-old woman is brought to the emergency room by her
husband. The woman complains of a sharp, intensive pain on the
left side of her chest, accompanied by shortness of breath and palpitations.
She fears that she had a heart attack. The results of her
physical examination and blood tests are normal. The pain ceased
after a few hours of observation and she was released.
3.155/ 1.
Similar situations have occured previously, although an organic cause
has never been demonstrated. What is the most likely diagnosis?
A) histrionic conversion reaction
B) malingering
C) anancastic neurosis (panic disorder)
D) hypochondriasis
E) compulsive personality disorder
3.155/2.
During these episodes of discomfort the patient talks about herself
as if being an independent observer. This is an example of
A) derealization
B) depersonalization
C) illusions
D) hallucinations
E) alienation
PSY-3.156.
Case Study:
A 39-year-old salesman presents at the emergency room complaining
of a severe headache localized to one side of his head. The physician
should inquire about all of the following, EXCEPT:
A) hallucinations and delusions
B) any trouble with the authorities
C) any history of a loss of consciousness
D) the need for the prescription of a pain killer
E) alcohol abuse
PSY-3.157.
Symptoms which are necessary in order to diagnose a panic disorder
include all of the following, EXCEPT:
A) the occurrence of at least three episodes in a 3-week period
B) the continuous presence of the symptoms for at least one month
C) the identification of an environmental stressor
D) an onset in young adulthood
E) the occurrence of spontaneous anxiety attacks
PSY-3.158
characteristics of conversion disorders include all of the following,
EXCEPT:
A) their incidence in children is equal in both sexes
3.162/3.
Although the exact mechanism of this disorder is not known, there
are some theories concerning the etiology. These include all of the
following, EXCEPT:
A) the pain offers a possibility for the patient to avoid an undesirable
situation
B) the patient did not learn to verbalize her emotions during childhood
C) the patient experienced a disease associated with severe pain
during her childhood
D) the patient attempts to mislead the physician in order to
achieve a better quality of care
E) the pain may be regarded as a stess reaction of the central
nervous system
PSY-3.163.
Statistically recognized risk factors of schizophrenia include all of
The following, EXCEPT:
A) a defective self development (defective self-object differentiation
and an increased susceptibility to narcistic injuries)
B) cultural, economical, and psycho-social stressors present in
the environment
C) birth in early spring
D) a schizophrenic amongst the patient's relatives
E) a history of a herpes simplex infection or viral encephalitis
PSY-3.164.
Which of the following is an unlikely precipitating cause of a psychotic
episode later diagnosed as schizophrenia?
A) alcohol abuse
B) a severe psychosocial stressor
C) a severe depressive episode
D) a traumatic event in the patient's life
E) the use of a psychostimulating drug
PSY-3.165
The most frequent type of schizophrenia among hospital admissions is:
A) the autistic type
B) the catatonic type
C) the hebephrenic type
D) the paranoid type
E) the undifferentiated type
PSY-3.166.
Statements characteristic for bipolar mood disorders include all of
the following, EXCEPT:
A) certain patients exhibit a congenital membrane defect affecting
the lithium-transport in red blood cells
B) each manic episode is followed by a depressive phase
C) the sex ratio of bipolar disorders is roughly equal
D) bipolar disorders usually have an onset before the age of 30
E) the levels of norepinephrine and its metabolites are frequently
found to be elevated in manic patients
PSY-3.167
The leading symptom of affective disorders is a disturbance of
B) fantasy
C) hallucination
D) illusion
E) phobia
PSY-3.180.
Case study:
A physician asks an elderly male patient what he had for supper the
previous day. The patient asserts that he had his christmas dinner
together with his wife and children. This is late June now and the
patient's wife died three years ago. Nobody visited the patient the previous
day. The patient's reply is characteristic of:
A) circumstantiality
B) confabulation
C) deja vu
D) a flight of ideas
E) an illusion
PSY-3.181.
Case Study:
A 30-year-old man complains of impotence. He thinks that strangers
on the street are laughing at him. He is sure that they know about his
problem and that they are probably responsible for the development of
his condition. This complaint should be regarded as a sign of:
A) concreteness of thought
B) delusions of reference
C) imaginativeness
D) decline of affect
E) somatic delusions
PSY-3.182
Which of the following is a best example for a double bind?
A) Mary's parents want her to wait to get married until she finishes
high school
B) John's parents encourage him to go to high school but want
him to decide about his own life
C) Joe's parents encourage him to go to high school but they
dissuade his sister from the same thing
D) Frank's parents encourage him to apply to a high school but
frequently remind him of the financial sacrifices his education
requires from the family
E) Sophie's parents encourage her to apply to a high school but
recommend to her to work for a few years first in order to earn
the costs of her education
PSY-3.183.
The psychic structure which regulates the conflicts between unconscious
drives and the reality is the:
A) ego
B) ego-ideal
C) id
D) preconscious
E) superego
PSY-3.184.
Homosexuality is characterized by all of the following statements EXCEPT:
PSY-3.190.
Case Study:
A 27-year-old woman is brought to the emergency room complaining
of shortness of breath, dizziness, and a tingling in her extremities.
Careful examination fails to discover any organic abnormalities. Which
of the following is the most likely cause of her symptoms?
A) situational reaction
B) endogenous anxiety
C) caffeine abuse
D) hyperventilation syndrome
E) post-traumatic stress disorder
PSY-3.191.
Correct statements about agoraphobia include all of the following, EXCEPT:
A) the affected person experiences an intensive, irrational fear of
leaving his/her home
B) the affected person realizes that the subject of his/her fear is
irrational
C) it is effectively relieved by antidepressants
D) behavioral therapy focuses on the phobia and neglects the
psychodynamics of the affliction
E) once a phobia is effectively eliminated, it will not re-occur
PSY-3.192.
A major side-effect of monoamino-oxidase inhibitor antidepressant
therapy is referred to as a "cheese reaction". Foodstuffs that may cause
such a hypertensive crisis include all of the following, EXCEPT:
A) coffee and tea
B) poultry liver
C) smoked fish
D) legumes
E) beer and red wine
PSY-3.193.
Case Study:
A middle-aged man becomes ill with Parkinson's disease. The prescribed
medication fails to improve his motor abnormalities. His mood is depressed.
He says he has lost his relish for life and the only thing he
does is sleep. The first steps of managing this patient include:
A) to admit him to a psychiatric ward with respect to a possibility
of suicide
B) reassuring the patient that the prescribed medications are
effective in Parkinson's disease
C) a discussion with the patient about his troubles and inquiry
about any suicidal ideations
D) referring the patient to a neurologist or a psychiatrist saying,
"let them hear his story"
E) scheduling frequent therapeutic settings and calling the attention
of the family members to the possibility of suicide
PSY-3.194.
Case Study:
A 41-year-old man complains that life does not give him what he
wants. He feels disappointed and unhappy. He was depressed for a
while after his girlfriend left him 8 years ago. What is the most likely
diagnosis?
A) psychogenic depression
B) schizophrenia
C) bipolar disorder; depressive phase
D) dysthymia (neurotic depression)
E) cyclothymia
PSY-3.195.
Which of the following personality traits have commonly been found as
characteristics of a premorbid personality preceding schizophrenia?
A) extreme dependence (strong relationship with the parents, fear
of being far from home)
B) social withdrawal; an inability for close interpersonal
relationships
C) insufficient socialization; cruelty to animals; pyromania; enuresis
D) extreme obedience; conformity; excellent academic results
E) none of the above
PSY-3.196.
Which of the following personality disorders is most likely to be
associated with a mood disorder?
A) schizoid personality disorder
B) paranoid personality disorder
C) borderline personality disorder
D) avoidant personality disorder
E) antisocial personality disorder
PSY-3.197.
Case Study:
A 39-year-old man complains of severe anxiety. He feels like a stranger
in his usual environment and settings. He has very strange thoughts
and he has to fight to subdue them. The first step of the management
of this patient is:
A) to have him admitted to a psychiatric ward
B) to ensure him that he has no mental disease
C) to explore the current situations of his life in order to determine
the subsequent steps
D) to inquire about his childhood events
E) to prescribe anxiolytics and to excuse the patient from work
PSY-3.198.
If one of two monozygotic twins becomes ill with schizophrenia, the
likelihood for the other twin to be affected is:
A) 95%
B) not any higher than the average likelihood in the general
population
C) the same as for a non-twin sibling
D) between 35 and 70%
E) 100%
PSY-3.199.
An intoxication caused by tricyclic antidepressants is most similar
to the one caused by:
A) amphetamines
B) atropine
C) barbiturates
C) cognitive impairment
D) EEG abnormalities
E) organic pathology
PSY-3.206.
Characteristics of delirium tremens include all of the following, EXCEPT:
A) an introductory grand mal seizure
B) auditory hallucinations associated with clear thoughts and
proper orientation
C) tremors and sweating
D) blackouts
E) disorientation
PSY-3.207.
A heroin overdose is characterized by all of the following symptoms
EXCEPT:
A) mydriasis
B) hypotension
C) diminished reflexes
D) coma
E) respiratory depression
PSY-3.208.
Dementia is characterized by all of the following statements, EXCEPT:
A) demented patients are often depressed
B) the ability to generalize from past experiences and to recognize
the relationship between similar situations is impaired
C) an early feature is an inability to recall events from the distant
past
D) demented patients may experience hallucinations
E) Creutzfeldt-Jakob disease is a dementia caused by a slow virus
infection
MULTIPLE CHOICE QUESTIONS WITH KEY ANSWERS / TYPE II
Every question or incomplete statement has only one answer in the
following combinations:
A) if the answers 1, 2, and 3 are true
B) if the answers 1 and 3 are true
C) if the answers 2 and 4 are true
D) if only the answer 4 is true
E) if all the four answers are true
Select one of these key combinations!!!
PSY-3.209.
Intelligence tests have which of the following characteristics?
1) they compare the performance of an individual as compared to
a large group
2) they are influenced by culture
3) they do not measure an individual's entire intellectual capacity
4) they define an IQ of 100 as average
PSY-3.210
When attempting to treat a patient with a paranoid personality
disorder the physician should:
1) avoid setting limits
2) apologize quickly for any mistakes he/she may make
at home
3.246/3.
The son remained silent and the father insisted on going home.
The following day the boy was found dead from a self-inflicted gunshot.
This case represents common errors in evaluating a suicide
attempt, including:
1) not adequately evaluating the son's emotions
2) not appreciating what the first suicide attempt meant to the
son and his father
3) not assessing adequately the father's capacity to support
his son
4) not hospitalizing the patient, even if it was against his will
PSY-3.247.
Which of the following symptoms are indicative of
major depression?
1) a loss of appetite; dyssomnia; disturbances of sexual function
2) abandoning one's previous social positions and roles in occupation
and in the family
3) any suicidal ideation or attempt
4) any abnormalities of the perception of reality, delusions,
hallucinations and confusion
PSY-3.248.
Conditions that may be associated with the catatonic syndrome
(rigidity, mutism, catalepsia, waxy flexibility) include:
1) an affective disorder
2) viral encephalitis
3) hypnosis
4) schizophrenia
PSY-3.249.
Uncommon side-effects of tricyclic antidepressant therapy include
which of the following?
1) a dry mouth
2) tremor
3) constipation
4) extrapyramidal movement disorders
PSY-3.250.
Which of the following somatic diseases may be associated with a
depression syndrome?
1) pancreatic carcinoma
2) hypertension
3) hypothyroidism
4) peptic ulcer disease
PSY-3-.251
Which of the following medications are capable of eliciting mania?
1) amphetamines
2) tricyclic antidepressants
3) corticosteroids
4) reserpine
PSY-3.252.
PSY -3.261.
Which of the following statements concerning interrelationships
between anxiety and depression are correct?
1) many depressed patients are anxious
2) many patients with a panic disorder will develop depression
3) the same therapy may be useful in both depression and anxiety
4) hereditary transmission is recognized in both depression and
panic disorder
MULTIPLE CHOICE QUESTIONS / TYPE I
Select the correct answers to the following questions!!!
...each qestion may have more than one correct answer.
PSY-3.262.
Which of the following conditions are associated with mutism?
A) alcohol withdrawal
B) conversion neurosis
C) catatonic schizophrenia
D) depression
E) Ganser's syndrome
PSY-3.263.
Echolaha is characteristic for:
A) catatonic schizophrenia
B) anorexia nervosa
C) Alzheimer's disease
D) infantile autism
E) petit mal epilepsy
PSY-3.264.
Characteristic symptoms of schizophrenia include:
A) compulsive thoughts
B) progressive dementia
C) depersonalization
D) waking up early in the morning
E) thought withdrawal
PSY-3.265.
Which of the following symptoms or findings suggest a poor prognosis
in acute schizophrenic psychosis?
A) an IQ above the average
B) flatness of affect
C) an abrupt onset
D) a normal premorbid personality
E) marked thought disorder
PSY-3.266.
Characteristic symptoms of morphine withdrawal include:
A) excessive yawning
B) hypotension
C) muscle spasms
D) dry conjunctiva
E) diarrhea
PSY-3.267.
89.C
90.A
91.A
92.C
93.E
94.E
95.E
96.A
97.E
98.99.A
100.C
101.A
102.D
103.104.D
105.A
106.A
177.B
178.D
179.D
180.B
181.B
182.D
183.A
184.C
185.B
186.D
187.D
188.D
189.A
190.D
191.E
192.A
193.C
194.D
265.BE
266.ACE
267.CE
268.ABCE
269.BDE
270.ACE
19.A
20.21.D
22.E
23.D
24.D
25.B
26.D
27.A
28.C
29.D
30.D
31.C
32.C
33.A
34.C
35.D
36.D
37.E
38.B
39.B
40.D
41.42.D
43.C
44.B
45.A
46.47.D
48.49.A
50.51.D
52.53.A
54.E
55.C
56.B
57.A
58.D
59.C
60.C
61.B
62.D
63.D
64.E
65.B
66.B
67.C
107.B
108.E
109.C
110.A
111.E
112.E
113.C
114.D
115.A
116.A
117.A
118.119.D
120.C
121.A
122.E
123.E
124.E
125.E
126.A
127.A
128.129.E
130.A
131.132.B
133.A
134.A
135.A
136.E
137.A
138.C
139.E
140.E
141.E
142.D
143.D
144.E
145.B
146.D
147.A
148.C
149.A
150.D
151.A
152.D
153.C
154.D
155.CB
195.E
196.C
197.C
198.D
199.B
200.E
201.D
202.D
203.E
204.D
205.C
206.B
207.A
208.C
209.E
210.C
211.E
212.213.E
214.215.E
216.B
217.A
218.E
219.C
220.C
221.D
222.A
223.C
224.E
225.A
226.A
227.A
228.E
229.C
230.D
231.C
232.C
233.D
234.E
235.236.B
237.A
238.C
239.E
240.B
241.E
242.A
243.E
68.B
69.B
70.E
71.B
72.C
73.C
74.C
75.C
76.C
77.D
78.D
79.B
80.E
81.C
82.B
83.E
84.E
85.E
86.E
87.D
88.E
156.A
157.C
158.D
159.D
160.E
161.D
162.DBD
163.A
164.C
165.D
166.B
167.B
168.D
169.B
170.B
171.D
172.A
173.174.B
175.C
176.B
244.C
245.A
246.BDA
247.A
248.E
249.D
250.B
251.A
252.C
253.E
254.255.A
256.257.B
258.A
259.E
260.A
261.E
262.BCD
263.ACD
264.CE
PEDIATRICS (PED-4)
SINGLE CHOICE QUESTIONS
Select the single best response to each of the following questions!!!
PED-4.2.
All of the following statements regarding amoebiasis (Entamoeba
hystolitica infection) are correct, EXCEPT:
A) the disease is transmitted by the ingestion of cysts
B) digestive enzymes release trophozoites from the cysts
C) bacteria of the intestinal flora also contribute to the intestinal
damage caused by the trophozoits
D) the intestinal lesions are superficial
E) hepatic abscesses area common complication
PED-4.3
All of the following statements regarding maple syrup urine disease
are correct, EXCEPT:
A) newborns are symptomless at birth
B) early symptoms include difficulties of feeding, irregular respiration
and a weak Moro reflex
C) spasms are rarely seen
D) the time of the onset of symptoms is the third to fifth day after
birth
E) the disease is associated with a branched-chain ketoaciduria
PED-4.6
All of the following statements concerning congenital adrenal
hyperplasia are correct, EXCEPT:
A) cortisol production is elevated in the second week following
birth
B) the overproduction of androgens causes masculinization of the
external genitals in females
C) the acute sodium deficiency adrenal crisis is due to deficient
aldosterone production
D) these infants have a decreased appetite and somatic growth is
impaired
E) an excessive sodium deficiency causes severe water loss and
dehydration
PED-4.7.7
All of the following statements about the adrenogenital syndrome are
correct, EXCEPT:
A) androgen hypersecretion in the adrenal medulla causes
virilization and increased protein anabolism
B) virilizing adrenal tumors are rarely palpable, but they do dislocate
the kidney
C) the urinary 17-KS levels are decreased
D) virilizing adrenal tumors do not cause excessive cortisol production
E) the skeletal muscles are well developed in both boys and girls
PED-4.8.
The most likely cause of goiter in a newborn is:
A) the maternal consumption of goitrogenic substances (foods)
B) congenital hypothyroidism
C) a severe peroxidase defect
D) an abnormality of the thyrolingual duct
E) congenital thyroiditis
PED-4.9.
All of the following statements about heart sounds in children are
correct, EXCEPT:
A) a third heart sound is commonly detected during childhood
B) the second heart sound is generated by the closing of the
semilunar valves
C) the intensity of the first heart sound decreases if the ejection
fraction increases
D) a fourth heart sound can only be heard if ventricular ejection
is impeded
E) the origin of normal heart sounds is obscure
PED-4.10.
Which of the following would differentiate most clearly between a
venous hum and the murmur caused by a patent ductus arteriosus?
A) the site of auscultation
B) auscultation during systole and diastole
C) a venous murmur is always soft
D) altering the patient's head position diminishes or accentuates
the intensity of the murmur
E) the intensity of the murmur is accentuated during exercise
PED-4.11
During the treatment of acute diarrhea, hypernatremic dehydration
develops, if:
A) the amount of fluid received orally is insufficient
B) the sodium concentration of the fluid received orally is 80-90 mmol/1
E) a marked leukocytosis
PED-4.25.
Which of the following statements regarding hypertrophic pyloric
stenosis is valid?
A) the disease is manifested during the first few days of life
B) metabolic acidosis is characteristic
C) the disease is manifested during the first 4-6 weeks of life
D) bilious vomit is a characteristic finding
PED-4.26.
Which of the following is a rare symptom of acute appendicitis?
A) epigastric pain radiating to the right lower quadrant
B) nausea, vomiting and moderate fever
C) diarrhea
D) leukocytosis (the white blood cell count is approximately 14,000
G/1)
E) tenderness at McBurney's point
PED-4.27.
A transient prolongation of the PR interval on the ECG is detected in:
A) acute rheumatic fever
B) digitalis therapy
C) massage of the carotid sinus
D) all of the above
E) none of the above
PED-4.28.
During which childhood age is the onset of acute lymphoblastic
leukemia most frequent?
A) 10-12 years
B) the neonatal period
C) adolescence
D) 3-5 years
E) 6 months
PED-4.29.
The most frequent cause of urinary tract infections in a young girl is:
A) bacterla which ascend through the urethra and the lower urinary tract
B) bacteria penetrating from adjacent organs via the lymphatic vessels
C) direct extension from adjacent organs
D) hematogenic dissemination
PED-4.31
A cerebral abscess most freqently occurs in the bacterral meningitis
that is caused by:
A) Meningococcus
B) Pneumococcus
C) Streptococcus
D) Haemophilus influenzae
PED-4.32.
Characteristics of hypertonic dehydration in infancy include all of
the following, EXCEPT:
A) a loss of consciousness
B) less decreased skin turgor relative to the severity of the
dehydration
C) abdomen is lardaceous to touch
D) serum sodium concentration is above 145 mmol/1
E) central nervous system complications , are relatively frequent
PED-4.33.
The inheritance patterns of the muscular dystrophies are markedly
different. The inheritance of progressive muscular dystrophy is:
A) sex-linked recessive
B) autosomal dominant
C) autosomal recessive
D) sex-linked dominant
E) autosomal recessive and sex-linked recessive
PED-4.34.
All of the following statements about a child with encopresis are correct,
EXCEPT:
A) the prevalence of encopresis in the general child population is 1-3%
B) the prevalence of encopresis among children with psychiatric
abnormalities is 5-7%
C) the etiologic background is a sensitivity to gluten
D) it is more common during daytime than in the night
E) impactation of the stool and constipation are frequently associated,
up to 80-95% of all cases
PED-4.35.
All of the following conditions can be diagnosed prenatally, EXCEPT:
A) arginino-succinic acidemia
B) a cystathionine synthase defect
C) Hunter's syndrome
D) the Lesch-Nyhan syndrome
E) the Guillain-Barr syndrome
PED-4.36.
From which of the following laboratory data is it possible to differentiate
between a hypothalamic-pituitary secondary hypothyroidism and
primary hypothyroidism?
A) a low serum T4 level and normal TSH levels
B) an elevated serum T4 level and low TSH levels
C) a low serum T4 level and elevated TSH levels
D) an elevated serum T4 level and elevated TSH levels
E) a low serum T4 level and elevated TSH levels
PED-4.37.
All of the following diseases are associated with an increased frequency
of some histocompatibility antigens, EXCEPT:
A) type I, insulin dependent diabetes mellitus
B) celiac disease
C) membranoproliferative glomerulonephritis
D) rheumatoid arthritis
E) ankylosing spondylitis
PED-4.38.
Bleeding, due to thrombocytopenia occurs if the platelet count is less
than:
A) 150,000 /ul
B) 100,000 /ul
C) 80,000 /ul
D) 50,000 /ul
E) 20,000 /ul
PED-4.39.
Possible causes of a tall stature in childhood include all of the following,
EXCEPT:
A) an eosinophilic adenoma of the pituitary
B) a chromophobic adenoma of the pituitary
C) Marfan syndrome
D) Hand-Schller-Christian disease
PED-4.40.
Now, that the long term prognosis of the acute leukemia of the
childhood improved considerably during the last ten years, there is
increasing interest concerning the "hidden places" where malignant
cells may survive. Which of the following is regarded as a "hidden
place"?
A) the muscles and bone
B) the skin and mucous membranes
C) the testis and the central nervous system
D) the pancreas
E) the liver
PED-4.41.
Possible causes of a fever of unknown origin include all of the following,
EXCEPT:
A) pyelonephritis
B) subacute bacterial endocarditis
C) Salmonella enteritis
D) hypothyroidism
E) thyroiditis
PED-4.42.
Zinc deficiency is a possible complication of all of the following conditions,
EXCEPT:
A) acrodermatitis enteropathica
B) Hirschprung's disease
C) celiac disease
D) phenylketonuria
E) kwashiorkor
PED-4.43.
In which case is the newborn considered live-born?
A) if the body mass exceeds 750 g
B) if the body mass at birth exceeds 500 g
C) if the heart beats and the newborn breathes and moves
D) if any of the life functions are detectable after birth
PED-4.44.
In which of the following cases is the newborn with a low birth
weight considered to be a premature newborn?
A) if the birth weight is less than 2,500 g
B) if signs of intrauterine retardation are detected
C) if the gestation period is shorter than 37 weeks
PED-4.51.
Which process is faster during the first month of life?
A) an increase of height
B) an increase of weight
PED-4.52.
How much is the head circumference of a mature, well-developed 6infant?
A) 43 cm
B) 38 cm
C) 46 cm
D) 50 cm
PED-4.53
What is the difference in the blood constitution between a 24-hourold
newborn and a healthy, 24-month-old child?
A) the newborn exhibits a higher hemoglobin level and a higher
white blood cell count
B) the newborn exhibits a higher hemoglobin level and a lower
white blood cell count
C) the newborn exhibits a lower hemoglobin level and a higher
white blood cell count
D) the newborn exhibits a lower hemoglobin level and a lower
white blood cell count
PED-4.54.
Case Study:
An 11-month-old infant is referred to you. The infant cannot sit up or
stand up, but crawls and plays with objects, understands plenty of
words and commands. The somatic growth is apparently normal. After
careful examination, the infant's psychic development is found to be
normal and an organic neurologic disorder is excluded. What would
be your advise to the patents?
A) to observe the child and repeat the examination at a latei date
B) to elevate the dose of the regular vitamin D
C) although the infant's hip joints have been found to be normal
in a physical examination, an x-ray of the hip joint is ordered
D) curative gymnastics should be recommended
PED-4.55.
At what age is the head size to body height ratio the highest?
A) in the newborn
B) in a 6-year-old child
C) in the adolescent
D) in the adult
PED-4.56
Case Study:
A 2-week-old infant is brought to your office. Two days ago the baby vomited.
The baby also has diarrhea. The mother tells you that the infant's
Appetite is good, and he voids large amounts of urine (the nappy is always wet).
On observation the infant is alert. What is the most likely diagnosis?
A) sepsis
B) gastroenteritis
C) intestinal malrotation
D) volvulus of the small intestine
E) overfeeding
PED-4.57.
How much is the energy requirement of a 4-week-old, normally developing
infant?
A) 100-150 kcal/kg/day
B) 200-250 kcal/kg/day
C) 300-350 kcal/kg/day
PED-4.58
Case Study:
A breast-fed baby is developing well. The baby's mother has no problem
with lactation. At what age would you introduce vegetable puree
to the diet?
A) at the age of 6 weeks.
B) at the age of 6 months
C) at the age of 9 months
D) at the age of 11 months
PED-4.59.
How much fluid does a 1-month-old, healthy infant require daily if
the body weight is 3,400 g and the external temperature is 25C?
A) 300 ml
B) 500 ml
C) 800 ml
D) 1,200 ml
PED-4.61.
Case Study:
The mother of a 2-week-old baby has no or very little breast milk.
Which of the following preparations would you tell the mother to use?
A) pasteurized mother's milk
B) 50% diluted cow's milk
C) Isomil (soy-based formula)
PED-4.62.
What is the protein requirement of a 2-month-old infant?
A) 1 g/kg/day
B) 2.5 g/kg/day
C) 10 g/kg/day
D) 4.5 g/kg/day
PED-4.63.
With what and in what ratio should the cow s milk be diluted for a
well-developed, 6-month-old infant?
A) there is no need for dilution
B) with 50% boiled water
C) 2 parts milk and 1 part water containing rice powder
D) 2 parts milk and 1 part tea containing saccharose
PED-4.64.
How much is the daily vitamin D requirement of a 6-month-old
healthy infant on an average mixed diet?
A) 2.5 g/day
B) 10 g/day
C) 5 g/day
D) 15 g/day
PED-4.65.
Possible causes of the development of rickets in a child regularly supplemented
with oral vitamin D include all of the following, EXCEPT.
A) an abnormality in the metabolism of vitamin D in the skin
B) an abnormality in the metabolism of vitamin D in the kidney
C) lipid malabsorption
D) hyperphosphaturia
PED-4.66.
Which of the following tests is not suitable to confirm the diagnosis of
rickets?
A) the serum inorganic phosphate level
B) an x-ray picture of the wrist
C) the serum calcium level
D) the serum 25-OH-D3 level
E) the serum alkaline phosphatase activity
PED-4.67. Single Choice Question
All of the following statements about vitamin A are correct, "EXCEPT:
A) vitamin A is needed for the formation. of a normal epithelium
and normal development
B) lipid malabsorption is a possible cause of vitamin A deficiency
C) a very low dietary lipid consumption is a possible cause of vitamin
A deficiency
D) crepuscular (twilight) blindness is a possible symptom of vitamin
A deficiency
E) muscular hypotonia is a possible symptom of vitamin A deficiency
PED-4.68.
All of the following statements about hypervitaminosis-A are correct,
EXCEPT:
A) the intake of a dose of 300,000 IU of vitamin A or the regular
intake of 1,500 IU of vitamin A daily causes the development of
hypervitaminosis within a short period
B) it is associated with a loss of appetite
C) it is associated with the occurrence of painful swellings over the
bones
D) it is associated with an increased cerebrospinal pressure
E) it is associated with skin petechiae
PED-4.69.
All of the following statements concerning vitamin B1 are correct,
EXCEPT:
A) it is a coenzyme in carbohydrate metabolism
B) it is heat stable
C) a carbohydrate-rich diet increases vitamin B1requirements
D) the symptoms of hypovitaminosis-B1 are fatigue, loss of appetite
and anemia
E) it can be found in milk, egg, yeast and bran
PED-4.70.
All of the following abnormalities of body constitution and function
can be detected in atrophy, EXCEPT:
A) the subcutaneous adipose tissue of the face is lost first
C) corticosteroid therapy
D) overeating, the lack of physical activity
E) hyperthyroidism
F) adiposogenital dystrophy (Frhlich's syndrome)
PED-4.78.
All of the following statements about adiposogenital dystrophy
(Frhlich's syndrome) are correct, EXCEPT:
A) the cause is a lesion of the hypothalamic area
B) most frequent cause is a tumor
C) symptoms of the disease include obesity, short stature and
hypogonadism
D) it is associated with mental retardation
E) diabetes insipidus is a possible complication
PED-4.79.
How much is the required daily water intake of a child who weighs 14 kg?
A) 500 ml
B) 1,000 ml
C) 1,700 ml
D) 2,000 ml
E) 2,700 ml
PED-4.80.
All of the following statements concerning fluid therapy are correct,
EXCEPT
A) it includes a maintenance dose of fluid and electrolytes, and
the administration of glucose for the prevention of ketosis
B) the maintenance dose of fluid should be adjusted to the energy
metabolism (and insensible losses)
C) the loss of water by means of insensible perspiration is approximately
50 ml/ 100 kcal (420 kJ daily: the volume generated
by oxidation should be substracted (17 ml/ 100 kcal)
D) the osmolality of the normal plasma is 350-360 mOsm/kg
E) the insensible perspiration increases during pyrexia, sweating
and phototherapy
F) the renal fluid loss is increased incase of a marked glucosuria
PED-4.81.
The minimal fluid requirement of a 6-month-old infant with mild
diarrhea is:
A) 50 ml/kg
B) 75 ml/kg
C) 150 ml/kg,
D) 300 ml/kg
E) 400 ml/kg.
PED-4.82.
What is the most simple method to control the correction of a 5%
dehydration?
A) a measurement of the body weight
B) a determination of the osmolality of the plasma
C) a measurement of the central venous pressure
D) a measurement of the blood pressure
PED-4.83
PED-4.87.
All of the following statements concerning hypotonic (hypenaremic)
dehydration are correct, EXCEPT:
A) the sodium concentration of the serum is below 130 mmol/1
B) the extracellular hyperosmolarity causes swelling of the cells
C) aldosterone secretion decreases because of the hyponatremia
D) cerebral edema develops in severe hypotonic dehydration
E) besides the serum sodium concentration, the total body water
is also important during the correction of the condition
PED-4.88.
All of the following statements concerning hypertonic
(hypernatremic) dehydration are correct, EXCEPT:
A) the fluid loss is restricted to the extracellulary fluid compartment
in case of a hypertonic dehydration
B) hypernatremia is a serum sodium concentration greater
than 150 mmol/I
C) possible complications of severe cases include fever, irritability,
spasms, coma and occasionally cerbral hemorrhage
D) possible causes include water deprivation, hyperventilation,
diabetes insipidus
E) rehydration must be carried out slowly, as the decrease in the
serum sodium concentration should not exceed 10 mmol/1 a day
F) the fluid loss is calculated from the sodium excess relative to
the normal sodium concentration and the volume of the
extracellular fluid
PED-4.89.
All of the following conditions may be associated with hypokalemia,
EXCEPT:
A) hyperaldosteronism (Conn's syndrome)
B) post-acidotic syndrome
C) Bartter's syndrome
D) acute renal failure
PED-4.90.
All of the following statements about rickets are correct, EXCEPT:
A) the effective metabolite of the vitamin D metabolism is
calcitriol or 1,25-(OH)2-D3
B) the synthesis of renal calcitriol is regulated by the sennn
calcitriol level
C) an insufficient absorption of calcium causes osteoid tissue formation
in the ossification zones
D) rickets is associated with hyperphosphaternia which tends to
increase the precipitation of calcium in the ossification zones
E) phosphatase activity is elevated in rickets
PED-4.91.
Possible symptoms and complications of rickets include all of the
following, EXCEPT:
A) the earliest symptom is craniotabes which, if not associated
with other symptoms, may be misdiagnosed
B) caput quadratum develops, with the swelling of the wrists and
the ankles
C) rachitic rosary and deformities of the thorax develop
D) mental retardation is a possible late complication
PED-4.98.
All of the following rules of the transportation of term and premature
newborns are correct, EXCEPT:
A) acute, life-threatening conditions should be managed in the
obstetric ward
B) a bolus infusion of a solution containing 10% glucose, occasionally
completed with bicarbonate administration via the
umbilical vein is useful before any transportation is attempted
C) the premature newborn should receive a glucose infusion during
prolonged transport
D) the newborn should be attended by a doctor or a trained nurse
E) a blood sample of the mother and full documentation of the
pregnancy, delivery and the peripartum period should be sent
with the infant
PED-4.99.
All of the following statements concerning esophageal atresia are
correct, EXCEPT:
A) any pregnancy complicated by hydramnios should be screened
for this anomaly
B) it is frequently associated with a tracheo-esophageal fistula
C) the problem might only be detected during the first feeding,
despite a thorough perinatal examination
D) an operation should be done as soon as possible
E) the upper stump must be continuously aspirated until a therapeutic
operation is performed and the newborn should be
placed in a half-sitting position
F) intubation might be necessary to avoid aspiration
PED-4.100.
All of the following statements concerning the newborn of a diabetic
mother are correct, EXCEPT:
A) most of these newborns, are overweight relative to the gestational
age
B) hypoglycemia, developing soon after birth, is common
C) tachypnea frequently occurs
D) the prevalence of hyaline membrane disease among these infants
is the same as in a control group of the same gestational age
PED-4.101.
Which newborn is the least prone to hypoglycemia?
A) a premature newborn with a low body weight relative to the
gestational age
B) a premature newborn with normal body weight relative to the
gestational age
C) a neonate born at term, with intrauterine retardation
D) the newborn of a diabetic mother
PED-4.102.
All of the following statements concerning persistent fetal circulation
are correct, EXCEPT:
A) it develops primarily following chronic fetal distress
B) the cause is a hyperthrophy or spasm of the vessels of the pulmonary
circulation
C) a marked right to left shunt is maintained by the open foramen
hypoperfusion
F) a persistent fetal circulation may develop
ED-4.107.
All of the following statements concerning IRDS (hyaline membrane
disease) are correct, EXCEPT:
A) it is manifested within a few hours following birth
B) tachypnea, jugular and intercostal retraction are observed
C) the observed expiratory grunting is a result of the closing of
the glottis, which aims to keep the alveoli open
D) the development of a pneumo-bronchogram on the chest x-ray
verifies IRDS
E) during the third stage, the diaphragm-lung and the heart-lung
borders are obscure on the chest x-ray
PED-4.108.
All of the following statements about the therapy of IRDS (hyaline
membrane disease) are correct, EXCEPT:
A) the aim of respiration therapy is to keep the alveoli open and
maintain a normal functional residual capacity
B) the aim of respiration therapy is to maintain the normal arterial
oxygen tension and to prevent an elevation of the carbon
dioxide tension
C) CPAP (continuously positive airway pressure) should provide
an airway pressure of 3-7 cm of water during spontaneous
respiration
D) the ratio of oxygen in the inspired air should be at least 50%
E) if, despite CPAP respiration, carbon dioxide fails to fall below
55 mmHg, then PEEP (positive end-expiratory pressure) respiration
is indicated
PED-4.109.
All of the following statements concerning pneumonia of a newborn
are correct, EXCEPT:
A) it may develop during the fetal period, during delivery, or
postnatally
B) an early rupture of the amnion plus maternal infections predispose
this condition
C) a group B streptococcus infection is a frequent cause
D) symptoms of the condition are similar to those in IRDS
E) an elevated or, occasionally, very low white blood cell count,
associated with a low platelet count are indicative of pneumonia,
rather than IRDS
F) a strong elevation of the serum IgG level is indicative for a
connatal pneumonia
PED-4.110. Single Choice Question
Which of the following mechanisms is not involved in the development
of the physiologic jaundice in the newborn?
A) toxic compounds present in the circulation
B) a shorter life span of the newborn's red blood cells
C) an elevated level of the non-conjugated bilirubin in the
newborn
D) the insufficient conjugation capacity of the liver
E) an enhanced enterohepatic circulation of bilirubin
PED-4.111.
Possible causes of the development of pathologic hemolysis associated with
hyperbilimbinemia in the newborn include all of the following, EXCEPT:
A) bacterial or viral sepsis
B) erythroblastosis
C) ABO incompatibility
D) vitamin K deficiency
E) red cell enzyme abnormalities
F) congenital abnormalities of the red blood cells
PED-4.112.
All of the following statements concerning the anemia of neonatal
hemolysic disease are correct, EXCEPT:
A) the lower limit of the reference range of the hemoglobin concentration
of a newborn during the first days is 8.5 mmol/1(14 g/dl)
B) the lower limit of the reference range of the hemoglobin concentration
of a 6-week-old infant is 6.5 mmol/1(10 g/dl)
C) the late anemia caused by an incompatibility develops 5-6
weeks after the blood exchange
D) during blood exchange irregular antibodies reach the organism,
this is the cause of the late anemia
PED-4.113.
Anti-D immunoglobulin is administered in all of the following conditions
EXCEPT:
A) to non-sensitized, D-negative mothers following the birth of a
D positive newborn
B) to non-sensitized, D-negative mothers following abortion
C) to non-sensitized. D-negative mothers following the first delivery,
if the newborn is D-negative
D) to D-negative individuals following the incorrect transfusion of
D-positive blood
PED-4.114.
All of the following statements concerning "rare" isoimmunization
are correct, EXCEPT:
A) a newborn with "rare" isoimmunization associated with jaundice
and anemia should only receive a transfusion of selected,
compatible blood
B) the mother, during transfusion of blood identical in main blood
groups, is still at risk for the development of a severe hemolysic complication
C) hemolysis following transfusion of blood identical in Rh(D) and
ABO blood groups is indicative of a "rare" isoimmunization
D) the direct Coombs' test usually becomes positive in case of
hemolysis caused by the transfusion of ABO-incompatible blood
PED-4.115.
Case Study:
A 3-week-old, well developed, breast-fed infant is still jaundiced.
Which of the following therapies is indicated?
A) the administration of barbiturates
B) exposure to blue light
C) a blood exchange
D) no treatment is necessary at this time
PED-4.116.
Meconium ileus is a possible early symptom of:
A) pyloric stenosis
B) Hirschsprung's disease
C) cystic fibrosis
D) intestinal perforation
PED-4.117.
Which of the following is the most likely cause of a bilious vomit of a
newborn?
A) esophageal atresia
B) pyloric stenosis
C) achalasia
D) volvulus of the small intestine
PED-4.118.
When should an x-ray examination be performed in case of anal
atresia?
A) immediately after detection of the anomaly
B) a few hours after birth
C) 12 hours after birth
D) the x-ray picture is unrevealing within one day after birth
E) a few days after birth
PED-4.119.
Clavicular fracture of a newborn is most commonly associated with
which of the following additional injuries?
A) epiphyseolysis of the humerus
B) a lesion of the phrenic nerve
C) a lesion of the brachial plexus
D) the rupture of the sternocleidomastoid muscle
PED-4.120.
All of the following statements concerning birth traumas of the skeleton
are correct, EXCEPT:
A) a fracture ofthe clavicle is quite common andit is frequently
undetected
B) the therapy of clavicular fractures includes stabilization of the
upper arm in an abducent position
C) a fracture of the humerus must be differentiated from a paresis
of the brachial plexus
D) the characteristic symptoms of a femoral fracture include crying
and pain upon movements of the lower extremity
PED-4.121. All of the following statements about neonatal lesions of the peripheral
nerves are correct, EXCEPT:
A) in the Erb-Duchenne form of paralysis, the cervical V-VI radices
are injured and a brachial type paralysis develops
B) in the Klumpke type of paralysis, the ceivical VII-VIII and the
thoracal I radices are injured and a paralysis of the forearm develops
C) Moro's reflex cannot be elicited in the Klumpke type of paralysis
D) the therapy of a paralysis of the upper arm and the forearm
includes stabilization of the extremity and physiotherapy
E) a lesion of the phrenic nerve causes a unilateral paralysis of
the diaphragm
PED-4.122.
Case Study:
A 6-hour-old newborn exhibits tachypnea and dyspnea and vomits repeatedly.
The body temperature of the newborn is normal. The physical
examination reveals a tympanic resonance over the left side of the chest-,
no respiratory sounds are audible over this side. The surface of the abdomen
is concave. What is the most likely cause of this condition?
A) IRDS
B) neonatal sepsis
C) left-sided pneumonia
D) a diaphragmatic hernia on the left side
E) pneumothorax
F) congenital valvular disease
PED-4.123.
Maternal factors which predispose the newborn to neonatal infections
include all of the following, EXCEPT:
A) urinary tract infections during pregnancy
B) febrile diseases or diarrhea during the peripartum
C) an invasive prenatal diagnostic examination
D) terbutaline sulphate (Bricanyl) therapy of the mother in an attempt
to prevent the abortion
E) bacteral colonization of the delivery channel
F) early rupture of the amnion
PED-4.124.
Indications of neonatal antibiotic prophylaxis include all of the following,
EXCEPT:
A) a peripartal maternal infection
B) an early rupture of the amnion
C) a fetid amniotic fluid
D) a prolonged and difficult delivery
E) a blood transfusion
F) a blood exchange
G) catheterization of the umbilical vessels
PED-4.125.
Specify the most suitable intervention for the inhibition of the vertical
transmission of a group B streptococcus infection:
A) oral antibiotic therapy of all of the carrier mothers
B) parenteral penicillin therapy of the newborns of the carrier
mothers in selected cases (early rupture of the amnion, premature
newborns etc.)
C) parenteral penicillin therapy of all of the carrier mothers and
their newborns
D) peripartal, intravenous ampicillin therapy of the carrier mothers
PED-4.126
Which of the following bacteria are the most frequent causative microorganisms of meningitis and sepsis during the neonatal period?
A) Streptococcus pneumoniae and Haemophilus influenzae
B) Staphylococcus and E. coli
C) E. coli and group B Streptococcus
D) E. coli and group A Streptococcus
E) Pseudomonas and Klebsiella
PED-4.127.
All of the following statements concerning necrotizing enterocolitis
(NEC) are correct, EXCEPT:
A) the disease is primarily manifested between the ages of 6-12 months
B) breastfeeding increases the resistance for developing NEC
C) an intestinal pneumatosis is of diagnostic value
D) bloody stool is observed in the majority of cases
E) in case of the failure of conservative therapy, an operation is indicated
PED-4.128
The occurrence of which of the following symptoms is the least likely
to occur in neonatal sepsis?
A) fever
B) the refusal of food
C) jaundice
D) lethargy
E) irritability
PED-4.129
Case study:
A 1-week-old infant is being suspected intestinal abnormaly
The mother tells that the baby defecates a green, mucous
stool 6-10 times daily. The body temperature is normal, the appetite of
the infant is normal, the somatic growth is sufficient and the nappy is
changed 10-12 times daily (it is always wet when replaced). The smell
of the feces is acidic. Which of the following statements is correct?
A) if the infant is breastfed only, the condition is severe
B) such stools may be normal in breastfed babies
C) such stools may be normal if the infant receives food preparations
with a high cereal content
D) the infant likely has a nosocomial enteral infection
PED-4.130 .
All or the following statements concerning pyloric stenosis are correct,
EXCEPT:
A) it is more common in boys than in girls
B) the usual time of the onset of symptoms is at the end of the
first month
C) the vomit is bilious
D) these patients usually show projectile vomiting
PED-4.131.
What is the most likely acid-base abnormality in congenital
hypertrophic pyloric stenosis?
A) respiratory alkalosis
B) none, as these is a normal acid-base status
C) metabolic acidosis
D) metabolic alkalosis
E) respiratory acidosis
PED-4.132.
Which of the following statements concerning the therapy of congenital
hypertrophic pyloric stenosis is correct?
A) a pyloromyotomy is indicated immediately
B) after normalization of the acid-base and electrolyte balance, a
pyloromyotomy has to be performed in each case
C) intestinal lymphangiectasis
D) celiac disease
E) galactosemia
F) congenital sucrase-isomaltase deficiency
PED-4.138.
Which of the following tests is the most informative in the recognition
of appendicitis in childhood?
A) the white blood cell count and the red blood cell sedimentation rate
B) a native abdominal x-ray
C) an abdominal ultrasound
D) the repeated physical examination of the abdomen
E) a rectal digital examination
PED-4.139.
All of the following diseases are to be excluded during the differential
diagnosis of an acute appendicitis, EXCEPT:
A) mesenteric lymphadenitis
B) bronchopneumonia
C) urinary tract infection
D) acute enteritis
E) ascariasis
F) Bornholm disease
G) lobar pneumonia (right lower lobe)
H) abdominal purpura (Henoch-Schnlein)
I) pneumococcal peritonitis
PED-4.140.
Case Study:
You are examining a 10-year-old boy. The child has been complaining of
pain in the ileocecal region for a few hours. The temperature is 37.9C.
On examination, the paryngeal mucosa is moderately hyperemic. Tenderness,
but no muscular defense, is detected in the ileocecal region. No
resistance is palpable during a rectal digital examination. What is your next action?
A) the diagnosis is pharyngitis associated with mesenterial
lymphadenitis: bed-rest at home and penicillin (Maripen) are indicatvd
B) the diagnosis is acute appendicitis: the patient is referred to a
surgical department
C) the diagnosis is pharyngitis and acute appendicitis: the patient
is referred to a hospital, close observation is indicated
PED-4.141.
Symptoms indicative for intussusception include all of the following,
EXCEPT:
A) a suddenly developing and periodically recurrent abdominal pain
B) the emptying of non-feculent, bloody mucus
C) the detection of fluid levels in the native abdominal x-ray
D) the emptying of purulent, bloody and mucous stool, preceded
by the development of fever
E) a palpable resistance in the abdomen
PED-4.142.
All of the following are possible causes of mechanical ileus, EXCEPT:
A) meconium plug
B) volvulus
C) invagination
D) Meckel's diverticulum
E) ulcerative colitis
PED-4.143.
Recognized causes of paralytic ileus include all of the following, EXCEPT:
A) an abdominal operation
B) a toxic Infection
C) renal colic
D) perforation peritonitis
E) intestinal helminthiasis
F) pneumonia
G) hypokalemia
PED-4.144.
Possible causes of constipation include all of the following, EXCEPT:
A) emotional factors
B) an inappropriate diet
C) congenital megacolon
D) increased vagal tone
E) laxative abuse
F) hypothyroidism
G) dolichocolon
PED-4.145.
Which of the following statements concerning congenital megacolon is
correct?
A) the cause of this condition is the lack of parasympathetic ganglia
in the distended portion of the colon or rectum
B) it may cause paralytic ileus
C) constipation is always present; diarrhea never occurs
D) on rectal digital examination, the rectal ampulla is found empty
E) both the narrow and the distended portion have to be removed
during the neonatal period
PED-4.146.
Which of the following statements about hernias is FALSE?
A) reposition of the incarcerated content 6 hours or more after the
incident is dangerous; an operation is indicated in these cases
B) a small inguinal hernia might spontaneously close during the
first year, but it is not necessary to wait until it closes
C) an inguinal hernia can only be examined in tranquil patients
D) the majority of umbilical hernias close spontaneously during
the first few years of life
PED-4.147.
All of the following statements about chronic persistent hepatitis are
correct, EXCEPT:
A) it may develop following an acute hepatitis B or a non-A non-B
hepatitis infection
B) symptoms of the condition include fatigue, a loss of appetite
and subicterus
C) hepatic enzyme activities in the serum are markedly elevated
D) a liver biopsy is necessary for the diagnosis
E) the histologic structure of the hepatic lobules is normal
F) the majority of cases heal but require control over a long period
of time
PED-4.148.
All of the following statements concerning chronic active hepatitis
are correct, EXCEPT:
A) one group of the chronic active hepatitises is caused by the
hepatitis B virus, the other group is of an autoimmune origin
(lupoid hepatitis)
B) the symptoms include a loss of appetite, hepatomegaly and
occasionally jaundice
C) the lupoid form is characterized by LE-cell positivity,
hypergammaglobulinemia and the presence of autoantibodies
in the serum
D) after a while this hepatitis heals on its own
E) a liver biopsy is necessary for the diagnosis
PED-4.149.
Possible causes of hepatic ciirhosis include all of the following, EXCEPT:
A) galactosemia
B) alpha1 antitrypsin deficiency
C) hepatitis A virus infection
D) hepatitis B virus infection
E) lupoid hepatitis
F) biliary atresia
PED-4.150.
The therapy of hepatic cirrhosis includes all of the following, EXCEPT:
A) drugs which are toxic to the liver
B) an energy-rich, fat-free diet and vitamin substitution are necessary
C) the protein intake must be restricted and the intestinal ammonia
production should be inhibited in cases of hyperammoniemia
D) in case of esophageal bleeding an immediate surgical shunt
preparation is the most straightforward therapeutic procedure
E) ascites formation may be decreased by a low salt intake and
the administration of spironolactone
PED-4.151.
All of the following statements about hepatic abscesses are correct,
EXCEPT:
A) possible causes include amebiasis, helminthiasis, sepsis
B) the symptoms are fever, tenderness and/or spontaneous pain
of the hepatic region
C) x-ray, ultrasound and isotope tests are indicated
D) it is usually associated with diaphragmatic pleuritis
E) the results of the blood tests are characteristic for an acute
inflammation ..
PED-4.152.
All of the following statements about Reye's syndrome are correct, EXCEPT,
A) Reye's syndrome is a certain form of hepatic encephalopathy
which is characterized by an abnormality of the urea cycle
B) it usually develops following a mild respiratory tract infection,
gastrointestinal disease or a varicella infection
C) salicylate administration may have a role in the development of
this syndrome
D) following a period of weakness and profuse vomiting,
neurologic symptoms develop
PED-4.160.
All of the following statements concerning rheumatic polyarthritis
are correct, EXCEPT:
A) it usually affects the great joints
B) the affected joints are swollen, warm, and movements are painful
C) it is associated with a high fever
D) joint deformities develop during healing if the appropriate
treatment is not introduced in time
E) the hip joint may also be affected
PED-4.161.
Symptoms of chorea minor include all of the following, EXCEPT:
A) muscular hypotonia
B) hyperkinesis
C) ataxia and impaired coordination
D) increased reflexes
E) emotional lability
PED-4.162.
All of the following statements concerning the therapy of rheumatic
fever are correct, EXCEPT:
A) penicillin therapy is indicated
B) in case of carditis, prednisone treatment is indicated for at
least 6 weeks
C) salicylate therapy alone is sufficient if the patient only exhibits
polyarthritic symptoms
D) bed rest is indicated until complete remission
E) if the disease is unresponsive to the above interventions, the
administration of azathioprine (Imuran) is indicated
PED-4.163.
Symptoms of subacute bacterial endocarditis include all of the following,
EXCEPT:
A) the initial symptoms include fatigue, pallor and a loss of appetite
B) initially a moderate, then a high-grtade fever is detected
C) microembolization of the skin and the kidneys
D) painful erythematous subcutaneous nodules about the tips of the
digits
PED-4.164.
Symptoms of a digitalis overdose include all of the following, EXCEPT:
A) nausea, vomiting
B) bradycardia, arrhythmia
C) a prolongation of the PR interval; 2nd or 3rd degree AV-block
observed on the ECG
D) atrial premature complexes
PED-4.165.
The effects of digitalis administration in a patient with cardiac
decompensation include all of the following, EXCEPT:
A) a declining positive central venous pressure
B) hepatomegaly becomes less pronounced
C) a short PR segment is observed on the ECG
D) the heart rate decreases
E) the volume of the urine increases
PED-4.166.
In which of the following arrhythmias is the administration of digitalis
CONTRAINDICATED?
A) ventricular paroxysmal tachycardia
B) supraventricular paroxysmal tachycardia
C) atrial flutter
D) atrial fibrillation
PED-4.167.
Which of the following statements about 2nd degree AV-block is correct?
A) each atrial contraction is followed by a ventricular contraction
B) it is usually caused by an organic disease
C) it is always manifested with severe symptoms
D) tachycardia is frequent in the condition
PED-4.168.
Which of the following statements cdncerning gallop rhythm is correct?
A) it is a symptom of congenital valvular diseases
B) it is a physiologic phenomenon
C) it is an obligatory symptom of myocarditis
D) it is regarded as a pathological sign during infancy and young
childhood
E) it is a harmless phenomenon during childhood
PED-4.169.
All of the following statements concerning tachycardias are correct,
EXCEPT:
A) possible causes of sinus tachycardia include fever,
hyperthyroidism and the consumption of caffeine
B) possible causes of acute supraventricular tachycardia include
fever, carditis and ephedrine administration
C) chronic supraventricular paroxysmal tachycardia is always
associated with valvular disease
D) atrial fibrillation is usually associated with heart disease
E) possible causes of ventricular fibrillation include digitalis toxicity
and cardiomyopathy
PED-4.170.
All of the following statements concerning the therapy of
tachycardias are correct, EXCEPT:
A) it is usually sufficient to manage the underlying cause of the
sinus tachycardia, digitalis may also be administered
B) after the neonatal period the first step in the therapy of a
supraventricular paroxysmal tachycardia is the administration
of oxprenolol (Trasicor)
C) propranolol is contraindicated in patients suffering from asthma
D) therapeutic agents applied in a supraventricular paroxysmal
tachycardia include digitalis, beta-blockers and verapamil
E) therapeutic agents applied in a ventricular paroxysmal tachycardia
include lidocaine, procainamide, phenytoin and electric cardioversion
PED-4.171.
All of the following statements concerning bradycardias are correct,
EXCEPT:
A) the possible causes of acute bradycardia include an atrioventricular
block due to hypokalemia, an increased intracranial pressure, an increased
PED-4.193.
Which of the following therapeutic interventions is prohibited in an
asthmatic crisis?
A) an increased intake of fluids
B) beta receptor agonists
C) beta receptor blockers
D) theophylline
E) corticosteroids
PED-4.194.
Which of the following interventions is contraiadicated in "status
asthmaticus'?
A) an aminophylline bolus (4-6 mg/kg), then continuous infusion
while monitoring the serum level
B) the application of an oxygen vapour tent
C) salbutamol inhalation
D) cortisone administered intravenously
E) infusion of a solution containing 0.2% saline and 5% dextrose
PED-4.195.
All of the following statements concerning the causative microarganisms
of a bacterial pneumonia are correct, EXCEPT:
A) a positive hemoculture is a reliable guide
B) the bacteriology of the laryngeal secretion is usually a reliable guide
C) a bacteriologic test of the tracheal secretion is usually reliable
D) a bacteriologic test of an occassionally present pleural exudate
is of diagnostic value
E) leukopenia indicates the possibility of a Gram-negative infective
microorganism
F) a rapid progression with abscess formation detectable on the
chest x-ray is indicative of a staphylococcal infection
PED-4.196.
All of the following statements concerning pneumococcal pneumonia
of infancy are correct, EXCEPT:
A) crepitation is not necessarily detected in the initial phase
B) meningism is a frequent complication
C) it is usually not preceded by an upper respiratory disease
D) the classic symptoms of the infiltration are typically first observed
on the 3rd-4th days
E) it cannot be prevented with vaccination against Pneumococcus
PED-4.197.
All of the following physical signs are characteristic of lobar pneumonia,
EXCEPT:
A) a duller percussion sound is heard over the affected lobe
B) bronchophony is detected over the affected lobe
C) bronchial respiratory sounds are heard over the affected lobe
D) a tympanic resonance is detected over the affected lobe
E) crepitation is audible over the affected lobe
PED-4.198.
All of the following microorganisms are associated with lung abscess
formation, EXCEPT:
A) Streptococcus pneumoniae
B) Klebsiella pneumoniae
C) Chlamydia trachomatis
D) Staphylococcus aureus
E) Haemophilus influenzae
PED-4.199.
All of the following statements concerning pneumonias caused by
Gram-negative microorganisms are correct, EXCEPT:
A) the pneumonia of a newborn, premature newborn or an
immunodeficient patient is usually caused by Gram-negative bacteria
B) klebsiella pneumonia is accompanied by the formation of sputum
that looks like currant jelly (Friedlnder's pneumonia)
C) pneumonia caused by gram-negative bacilli has a high mortality rate
D) gram-negative bacilli have a tendency to cause lung infections
in a previously-well adult host
PED-4.200.
All of the following statements concerning the differentiation of viral
and bacterial pneumonias are correct, EXCEPT:
A) the white blood cell count in a viral pneumonia is typically
lower than in a bacterial pneumonia
B) viral pneumonia of the infants is always of a mild severity
C) the progression of a viral pneumonia is slower
D) a lobar infiltration is usually indicative of a bacterial origin
PED-4.201.
Which of the following statements about interstitial plasmocytic
pneumonia is correct?
A) bronchial respiratory sounds are heard over the lung fields
B) crepitations are heard over the entire lung
C) it is manifested in newborns with a low birth weight, at the age
of 3-8 weeks
D) the onset is after the age of 4 months
E) the patients exhibit a hoarse cough
PED-4.202.
All of the following statements about pneumonia caused by
Pneumocystis carinii are correct, EXCEPT:
A) the incubation period is 3-8 weeks
B) premature newborns and immunodeficient patients are at a
higher risk
C) the clinical course is acute (several hours)
D) the presenting symptoms are marked tachypnea, cyanosis,
pallor
E) a frosted glass-like shadow is obseived on the x-ray
F) the therapeutic drug of choice is trimethoprim/sulfamethoxazole
PED-4.203.
Which of the following procedures is reliable in the diagnosis or exclusion
of a foreign body in the airways?
A) a physical examination
B) a thorough history taking
C) bronchoscopy
D) chest transillumination (Holzknecht's sign)
E) chest x-ray
PED-4.204.
E) a vitamin C deficiency
F) rickets
PED-4.210.
All of the following interventions cause an iatrogenic immune defect,
EXCEPT:
A) prolonged treatment with corticosteroids
B) cytostatic therapy
C) BCG vaccination
D) splenectomy
PED-4.211.
Diagnostic criteria of juvenile rheumatoid arthritis (JRA) include all
of the following, EXCEPT:
A) the onset is before the age of 16
B) a chronic inflammation of one or more joint
C) rheumatoid factor (RF) positivity, demonstrated at least once
D) an arthritis of at least 6 week duration
E) if other possible chronic arthritides are excluded
PED-4.212.
Infectious and post-infections arthritises include all of the following,
EXCEPT:
A) bacterial arthritis
B) viral and fungal arthritis
C) Lyme-arthritis
D) arthritis following a Yersinia infection
E) psoriatic arthritis
PED-4.213.
All of the following statements concerning the systemic form bf juvenile
rheumatoid arthritis (Still's disease) are correct, EXCEPT:
A) an intermittent fever is detected
B) maculo-papulous eruptions are observed, primarily on the
trunk
C) mild to severe joint symptoms occur, which might be
manifesed several days or weeks after the onset of fever and
the eruptions
D) a generalized lymphadenopathy is a usual complication
E) the white blood cell count is normal or low
F) the titer of the circulating immune complexes is high
G) it might be accompanied by pericarditis, myocarditis
PED-4.214.
All of the following rules of the therapy of juvenile rheumatoid arthritis
(Still's disease) are correct, EXCEPT:
A) a steroid is administered first
B) non-steroid anti-inflammatory drugs have a primary role in
the therapy
C) as soon as possible, complex physiotherapy should be
started
D) in case of the development of more severe symptoms, the patient
should be admitted to a pediatric department
E) growth retardation is a major hazard of using prolonged
corticosteroid treatment in children
F) the patient should be seen by the family doctor once every
Month
PED-4.215.
Possible therapeutic interventions in allergic diseases include all of
the following, EXCEPT:
A) avoiding contact with the allergen
B) drug therapy
C) antimicrobial drugs
D) immunotherapy (desensitization)
E) prophylaxis (e.g. breast feeding)
PED-4.216.
All of the following statements concerning urticaria are correct,
EXCEPT:
A) exposure to cold and certain foods might precipitate it
B) the direct cause is an early type hypersensitivity reaction associated
with the liberation of histamine
C) laryngeal edema is a possible complication
D) beta receptor agonists are the effective tools of therapy
E) cyproheptadine (Peritol), among others, is an effective medication
F) in severe cases epinephrine and steroid administration are indicated
PED-4.217.
Case Study:
An 18-month-old infant is brought to your office. The parents tell you
that the infant has always been pale; the infant's appetite is changing;
and they report recurrent upper respiratory infections. The laboratory
results are as follows: hemoglobin: 4.7 mmol/1; hematocrit: 25%; serum
iron: 6 mol/1; total iron binding capacity (TIBC): 78 mol/1;
reticulocyte count: 3%o; platelet count: 200 G/1.
What is the most likely diagnosis?
A) minor beta thalassemia
B) aplastic crisis of a hemolytic anemia
C) iron deficiency anemia
D) initial phase of a malignancy
E) sideroachrestic anemia
PED-4.218.
All of the following results are indicative for an iron deficiency,
EXCEPT:
A) a low serum iron level
B) an elevated total iron binding capacity (TIBC)
C) a low serum ferritin level
D) large, hypochromic red blood cells observed in the peripheral
blood smear
E) anemia
PED-4.219.
Possible causes of folate deficiency anemia include all of the following,
EXCEPT:
A) malabsorption
B) parasite infestation
C) certain drugs
D) feeding with goat's milk
E) vitamin B 12 deficiency
F) increased utilization of folic acid due to hemolysis
PED-4.220.
A patient is found to have a macrocytic anemia. Possible causes include
all of the following, EXCEPT:
A) celiac disease
B) pernicious anemia
C) chronic bleeding
D) methotrexate therapy
E) folic acid deficiency
PED-4.221.
Characteristics of infectious anemia include all of the following, EXCEPT:
A) a low serum iron level
B) a normal total iron binding capacity (TIBC)
C) a normal or elevated serum ferritin level
D) the ratio of the erythroid cells is decreased
E) the reticulocyte count is low
PED-4.222. Single Choice Question
All of the following diseases are associated with a decreased production
of red blood cells EXCEPT:
A) iron deficiency anemia
B) leukemia
C) hypothyroidism
D) the early type anemia of a premature newborn
E) renal failure
PED-4.223.
Case Study:
Which of the following is the most important therapeutic intervention in
familial spherocytosis of a 6-year-old child, who frequently becomes anemic?
A) a transfusion of packed red blood cells
B) a splenectomy
C) the prolonged administration of steroids
D) immunosuppressive therapy
E) iron replacement therapy
PED-4.224.
Which of the following signs is necessary for the diagnosis of an
autoimmune hemolytic anemia?
A) the concentration of hemoglobin is lower than 6.0 mmol/1
B) cold agglutination is detectable
C) the reticulocyte count is above 100 0/00
D) a positive direct Coombs' test
PED-4.226.
Which of the following interventions is not suitable for the therapy
of idiopathic thrombocytopenic purpura (ITP)?
A) glucocorticoid therapy
B) intravenous immunoglobulin therapy
C) anabolic hormone therapy
D) plasmapheresis
E) azathioprine (Imuran) therapy
PED-4.227.
All of the following laboratory findings are characteristic for
PED-4.260.
Case Study:
A 13-year-old girl with treated diabetes is brought to you because of a
loss of consciousness. Which of the following should you check
immediately?
A) if a respiratory abnormality is present, or if skin is cold and dry
B) if the patient received an insulin dose in the normal time
C) if the patient missed a meal
D) if an additional acute disease is present
E) if the patient has experienced emotional stress
F) if the patient experienced some type of head trauma
G) if some type of drug intoxication is present
H) all of the above
PED-4.261.
Case Study:
A 13-year-old girl with treated diabetes is brought to you because of
a loss of consciousness. The time of the last insulin injection is unknown.
Her skin is dry; respiration is more frequent and deeper.
Which of the following do you recommend?
A) the girl should be taken home and the prescribed insulin dose
administered
B) to measure her blood glucose and having the result, decide to
refer the patient to the hospital or release her home
C) refer the patient to a hospital
PED-4.262.
What is the following calculation used for?
(U.V) /P
- if U is the urinary concentration of a given substance, V is the
urinevolume during a unit of time, P is the concentration of the given
substance in the plasma A) the renal clearance of a given substance
B) the renal plasma flow
C) the renal blood flow
D) the tubular secretion of a given substance
E) the tubular reabsorption of a given substance
PED-4.263.
Possible causes of hematuria include all of the following, EXCEPT:
A) acute glomerulonephritis
B) cystitis
C) nephrolithiasis
D) Henoch-Schonlein purpura
E) heavy physical exercise
F) mumps
PED-4.264.
What has to be done in case of recurrent pyuria?
A) specific drug therapy
B) morphology and function of the kidneys plus the lower and
upper urinary tract should be examined
C) a concentration test; followed by the examinations in point (B)
above
PED-4.265.
What is significant bacteriuria?
A) a few colonies of the same microorganism
B) over 100,000/ml of a mixed cultivation
C) over 100,000/ml of the same microorganism
D) over 1,000/ml E. coli and proteus
E) over 1,000,000/ml of a mixed cultivation
PED-4.266.
All of the following statements concerning acute poststreptococcal
glomerulonephritis are correct, EXCEPT:
A) it can be prevented with the early antibiotic therapy of
streptococcal infections of the upper respiratory tract and the skin
B) exacerbation of an acute glomerulonephritis is frequent in the
course of a chronic nephritis
C) the prognosis of the disease in childhood is usually good
D) a hypertensive encephalopathy may be the first symptom of the
disease
PED-4.267.
Possible complications of acute poststreptococcal
glomerulonephritis include all of the following, EXCEPT:
A) hyperkalemia
B) hypermagnesiemia
C) encephalopathy
D) pulmonary edema
E) anuria
PED-4.268.
Typical laboratory alterations in an acute poststreptococcal
glomerulonephritis include all of the following, EXCEPT:
A) an increased red blood cell sedimentation rate
B) a normal or increased C3 complement level in the serum
C) hematuria, proteinuria and granular casts in the urine
D) the antistreptolysin titer in the serum is usually elevated
E) elevated serum creatinine and blood urea nitrogen levels
F) anemia
PED-4.269.
Common complications of an acute poststreptococcal
glomerulonephritis include all of the following, EXCEPT:
A) left-sided heart failure
B) encephalopathy
C) hyperkalemia
D) uremia
E) hemorrhagic diathesis
PED-4.270.
All of the following statements concerning idiopathic nephrotic syndrome
are correct, EXCEPT:
A) the development of edema is caused by hypoproteinemia
B) an increased reabsorption of sodium is an additional cause for
the edema formation
C) diarrhea is a possible complication of the condition
D) serum lipid levels are modestly decreased
PED-4.271.
All of the following statements concerning idiopathic nephrotic syndrome
are correct, EXCEPT:
A) the onset is usually between 1-6 years of age
B) the histology reveals a "minimal change" process
C) the early development of renal failure is characteristic
D) patients usually do not exhibit hypertension
E) hyperlipidemia is usually present
PED-4.272.
Which of the following drugs is used first during the therapy of the
"minimal change" form of the nephrotic syndrome of childhood?
A) prednisone
B) chlorambucil
C) cyclophosphamide
D) prednisone + chlorambucil
E) prednisone + cyclophosphamide
PED-4.273.
When is a patient with a nephrotic syndrome considered steroidresistant?
A) if microhematuria is detected from the beginning
B) if high doses of steroid are needed to relieve symptoms
C) if a marked cushingoid type constitution is observed
D) if proteinuria is present following 2 months of prednisone
therapy (60 mg/m2 administered continuously for 4 weeks,
then alternatingly for 4 weeks)
E) if hypertension develops during treatment
PED-4.274.
The surgical therapy of vesicouretheral reflux is indicated:
A) in case of prolonged and marked reflux or if renal fibrosis
progresses
B) if, following 3 months of antibiotic therapy the reflux is still
present
C) if the reflux is bilateral
D) never, the reflux can improve without therapy
PED-4.275.
Possible complications of a unilateral renal vas aberrans include all
of the following, EXCEPT:
A) obstruction of the ureter
B) enlargement of the pyelon
C) recurrent abdominal pain
D) oliguria
E) hematuria
PED-4.276.
All of the following statements concerning factors which determine
renal stone formation are correct, EXCEPT:
A) the most common cause of the formation of calcium stones
during childhood is idiopathic hypercalciuria
B) urinary tract infections and an alkaline urine pH favor the
formation of MgNH4-phosphate stones
C) the formation of calcium-phosphate stones can be prevented
with regular vitamin D administration
D) urate stones when there is a massive tumor cell breakdown
PED-4.282.
All of the following interventions are used for the treatment of chronic
renal failure (endogenous creatinine clearance is 40 ml/min/ 1.73 m2),
EXCEPT:
A) protein intake is strongly restricted
B) salt intake is restricted if edema or hypertension develops
C) water intake is not restricted
D) occasionally 1,25(OH)2-D3 is administered
E) a transfusion is only indicated if the anemia is severe
PED-4.283.
Characteristics of hemolytic uremic syndrome (HUS) include all of
the following, EXCEPT:
A) initial symptoms are diarrhea, vomiting and fever
B) later symptoms include pallor, suffusions on the skin, oligo-anuria
C) anemia, thrombocytopenia and uremia can develop
D) microcytosis is observed on the blood smear
E) the serum creatinine concentration is normal
PED-4.284.
Characteristics of a cerbral paresis in childhood include all of the
following, EXCEPT:
A) their possible causes are early central nervous system lesions
such as hypoxia, intracranial hemorrhages and meningitis
B) they are always associated with severe mental retardation
C) movement disorders originating in the central nervous system
dominate the clinical picture
D) epilepsy, dyslexia and abnormalities of the special senses are
common complications
E) rehabilitation training at an early age may result in considerable
improvement
PED-4.285.
Which forms of neurorehabilitational therapy are indicated in a
young infant with cerebral damage, to overcome the disturbances of
movement coordination and the regulation of muscular tone?
A) frequent physical activity, regular movement and rotation of
the extremities
B) regular massage and moving of the hypotonic extremities
C) drug therapy (muscle relaxants in case of increased muscular
tone)
D) regular training of the congenital movement patterns
E) weekly training of the congenital, elementary movement
patterns
PED-4.286.
Possible intracranial causes of a headache include all of the following,
EXCEPT:
A) migraine
B) cerebral edema
C) hypertension
D) headache following lumbar puncture
E) meningitis and encephalitis
F) Guillain-Barr syndrome
G) cerebral tumor
PED-4.287.
Recognized causes of vomiting include all of the following, EXCEPT:
A) cerebral edema
B) meningism and meningitis
C) cerebellar tumor
D) cerebral abscess
E) hypernatremia
F) migraine
PED-4.288.
Which of the following interventions should be avoided in case of
cerebellar edema?
A) hyperventilation, to decrease the pCO2 to 25-27 mmHg
B) the administration of mannitol and furosemide
C) the intravenous administration of glycerin
D) treatment of the underlying disease
E) ventricular drainage
F) high dose steroid administration
PED-4.289.
All of the following statements concerrning a cerebellar abscess are
correct, EXCEPT:
A) it may be a complication of otitis, sinusitis or head trauma
B) a cardiac anomaly with a right to left shunt predisposes for the
condition
C) a cerebrospinal fluid pressure increase is possible
D) focal neurologic symptoms might develop
E) the cell count in the cerebrospinal fluid is always elevated
PED-4.290.
All of the following statements concerrning a chronic subdural
hematoma in infancy are correct, EXCEPT:
A) development of the hemorrhage takes weeks to months
B) the cause frequently remains obscure
C) the fonticuli are hard and hemorrhages are observed in the
retina
D) hydrocephalus does not develop because of the slow progression
of the hemorrhage
PED-4.291.
All of the following statements concerrning the Guillain-Barr syndrome
are correct, EXCEPT:
A) a symmetrical, flaccid paralysis and abnormality of sensation
are characteristic for the disease
B) the disease improves spontaneously despite its long clinical
course
C) cerebrospinal fluid tests reveal markedly elevated cell counts
with normal protein and glucose concentrations
D) differentiation of the disease from poliomyelitis is difficult in
some cases
PED-4.292.
All of the following statements concerrning peripheral facial nerve
paralysis are correct, EXCEPT:
A) possible causes include birth trauma and edema formation in
the neonatal period
PED-4.297.
All of the following statements concerning the therapy of epilepsy
are correct, EXCEPT:
A) the therapeutic drug may be withdrawn only after a
symptomless period of several years
B) the duration of drug therapy depends on the type of epilepsy
C) in case of the presence of EEG abnormalities the therapeutic
drug should not be withdrawn
D) the time of discontinuing drug therapy also depends on the
age of the patient
PED-4.298.
Symptoms of a cerebellar tumor in childhood include all of the following,
EXCEPT:
A) difficulties of coordination
B) nystagmus
C) cerebral vomiting, especially in the morning
D) obesity
PED-4.299.
What is the prognosis of minimal cerebral dysfunction (MCD) or the
chronic organic psychosyndrome in childhood? Which of the following
statements is FALSE?
A) despite early diagnosis and care, the abnormality passes through
childhood and adolescence and is present until adulthood
B) if the condition is undetected, the child becomes frustrated
and neurotic
C) tolerance by the family and in the school prevents any abnormalities
in personality development
D) drug therapy for the disorder is also possible
PED-4.300.
Which of the following microorganisms cause osteomyelitis most frequently?
A) Haemophilus influenzae
B) Salmonella
C) Streptococcus pyogenes
D) Staphylococcus aureus
PED-4.301
All of the following statements about the therapy of acute osteomyelitis
are correct, EXCEPT:
A) a blood sample is taken immediately for hemoculture
B) therapy is started after receivivg the bacteriology results
C) therapy is continued for 4 weeks following cessation of the
acute symptoms
D) the earliest alterations on the x-ray develop 10-14 clays after
the onset of the disease
E) immobilization of the affected extremity is important
PED-4.302.
All of the following statements about purulent arthritis are correct,
EXCEPT:
A) the clinical picture is similar to that of osteomyelitis
B) a hemoculture is needed for the diagnosis to be made
C) there is no need for diagnostic/therapeutic punctures
D) therapy is started with antibiotics
C) acetylsalicylic acid
D) methophenazate (Frenolon)
PED-4.332.
The therapy of Amanita phalloides intoxication includes all of the
following, EXCEPT:
A) gastric lavage, even after 24 hours
B) continuous duodenal aspiration
C) intestinal irrigation
D) the subcutaneous administration of heparin
E) infusion
PED-4.333.
Which of the following interventions should not be done in gasoline
intoxication?
A) gastric lavage
B) the administration of liquid paraffin
C) the administration of antibiotics
D) the administration of drugs affecting the circulation
PED-4.334.
What is the first symptom of salicylate intoxication?
A) skin and mucosal hemorrhages
B) sweating
C) hyperventilation
D) coma
E) spasms
PED-4.335.
Conditions which cause fever directly include all of the following, EXCEPT:
A) diabetes insipidus during infancy
B) blood transfusions
C) infections
D) hyperparathyroidism
E) autoimmune diseases
F) toxic goiter
PED-4.336.
Possible causes of a fever of non-infectious origin include all of the
following, EXCEPT:
A) hyperthyroidism
B) neuropathy
C) hypernatremia
D) a regulatory imbalance of the autonomic nervous system
E) epilepsy
F) atropine intoxication
PED-4.337.
Conditions which may be associated with respiratory arrest include
all of the following, EXCEPT:
A) an acute airway obstruction
B) an asthmatic crisis
C) bilateral valve pneumothorax
D) severe hypercapnia
E) impaction of the medulla oblongata (tonsillar herniation)
PED-4.338.
What is the correct sequence of the steps of resuscitation?
A) providing open airways; cardiac massage; administration of drugs
B) mouth to mouth breathing; cardiac massage; administration of
drugs and infusions; ECG control
C) providing open airways; mouth to mouth breathing; cardiac
massage; administration of drugs and infusions; ECG control
D) cardiac massage; mouth to mouth breathing, drug administration
PED-4.339.
Which is the most straight-forward method to ensure ventilation of
the lung in a state of clinical death?
A) the administration of oxygen via a nasal-pharyngeal tube
B) thoracic compression
C) following aspiration of the airways, the simultaneous application
of mouth to mouth breathing and cardiac massage
D) the administration of drugs which stimulate respiration and
cardiac function
E) artificial maintenance of the circulation
PED-4.340.
Possible complications of positive pressure artificial respiration include
all of the following, EXCEPT:
A) hypoventilation
B) hyperventilation
C) gastric distension
D) cardiac failure
E) peripheral circulatory failure
F) pneumothorax; pneumomediastinum
G) iatrogenic infection
PED-4.341.
Therapeutic interventions applied in pulmonary edema include all of
the following, EXCEPT:
A) treatment of the underlying disease
B) administration of 100% oxygen via a laryngeal tube or mask
C) CPAP mode respiration
D) respiration with positive airway pressure
E) vigorous diuretic treatment
F) the administration of digitalis and aminophylline
PED-4.342.
Which of the following are possible symptoms of septic shock?
A) isosthenuric polyuria
B) respiratory alkalosis; a loss of consciousness; a blood pressure
drop; acrocyanosis: azotemia; disseminated intravascular coagulation
C) urticaria; laryngeal edema; asthmatic crisis
D) none of the above
PED-4.343.
Symptoms of the late phase of septic shock include all of the following,
EXCEPT:
A) a blood pressure drop and tachycardia
B) pallor
C) lethargy
D) azotemia
PED-4.364.
All of the following statements concerning superficial fungal infections
are correct, EXCEPT:
A) microsporiasis and trichophytiasis are superficial fungal infections
B) Microsporium and Trichophyton cause red, scaly and round
lesions
C) if the hair or nails are involved, griseofulvin is the treatment of
choice
D) tinea pedis occurs most often in prepuberal children
PED-4.365.
All of the following statements about scabies are correct, EXCEPT:
A) the primary lesion is a few millimeters long, scratch-like duct
with a vesicle at the end, from which the mite can be removed
with a neddle
B) the site of predilection is the interdigital area but it might affect
other areas as well
C) it is usually associated with severe pruritus
D) the whole family should be examined and treated
E) the primary lesion is usually not superinfected
F) lindane and permethrin are used in the treatment of scabies
PED-4.366.
At what age should strabismus therapy be started?
A) at the age of 1 year
B) at the age of 3-4 years
C) before the child starts primary school
D) immediately after the diagnosis
PED-4.367.
Which of the following conditions is not characterized by
macroglossia?
A) cretinism (hypothyroidism)
B) glycogen storage disease
C) lymphangioma
D) macrocytic anemia
E) BeckwitWiedemann syndrome
PED-4.368.
In order to prevent caries formation, all of the following rules should
be followed, EXCEPT:
A) pregnant mothers of children under the age of 8 months
should not receive tetracycline therapy
B) candies and syrups should be excluded from the diet of the
infant and the child
C) vitamin D administration is continued into childhood if caries
develop
D) fluoride is administered after the infant's body weight has
reached 7 kg, the administered dose depends on the fluoride
content of the drinking water
E) meals which require appropriate chewing are preferred
F) regular brushing and flossing are recommended
PED-4.369.
Which of the following statements about recurrent abdominal pain
in childhood is FALSE?
A) the peak of incidence is at the age of 9-10 years
B) the most common localization is the periumbilical area
C) the pain is colicky, sometimes torturing
D) it is usually associated with muscular defense or pronounced
abdominal tenderness
PED-4.370:
The therapy of childhood vulvovaginitis includes all of the following,
EXCEPT:
A) if the cause is a fungal infection, nystatin (Nystatin),
natamycin (Pimafucin) or clotrimazole (Canesten) should be
applied locally
B) if the cause is a trichomonas infection, metronidazole (Klion)
should be used
C) in case of bacterial infection, specific antibiotic treatment is indicated
D) irrigation with potassium permanganate solution is useful in
all cases
PED-4.371.
Possible causes of a diffuse enlargement of the abdomen include all
of the following, EXCEPT:
A) enteral infections
B) malabsorption syndrome
C) pyloric stenosis
D) Hirschsprung's disease
E) intestinal perforation
F) hypokalemia
G) Wilms' tumor
PED-4.372.
Case Study:
A 3-year-old boy is brought to your office by his mother. The mother
says that the child developed a soar throat and fever every 3rd-4th
week ever since he has attended nursery school. The physical examination
revealed modestly enlarged tonsils. What should be done?
A) cultivation of the pharyngeal discharge; if it is negative, the mother
should be reassured that such symptoms commonly develop
during the first few months of attending a nursery school
B) order a complete laboratory check-up
C) a gamma globulin injection should be given regularly, (once a
month)
D) penicillin tablets should be given for 10 days as a prophylaxis
E) a tonsillectomy is indicated
F) an extensive immunological examination is indicated
PED-4.373.
Case Study:
A 3-month-old infant girl is brought to your office with the symptoms of
a long-standing rhinitis and difficulties in feeding. Her birth weight was
4,000 g and her physiologic jaundice ceased on the 28th day. The infant
also has constipation and she cannot elevate or hold her head. The mother
says that she has never seen her smile. On examination: the rectal
temperature is 36C, her skin is dry, her mouth is open and an umbilical
hernia is detected. Tracheal rales are audible. Auscultation of the lungs
and the heart is unrevealing. The size of the liver and the spleen is normal.
The movements of the infant are sluggish and her mood is indifferent.
What is the most likely cause of her symptoms?
A) bilirubin encephalopathy
B) hypothyroidism
C) Hurler's syndrome (gargoylism)
D) congenital cytomegalovirus infection
E) Crigler-Najjar syndrome
PED-4.374.
Case Study:
During the chest x-ray examination of a 6-year-old child, a distinct
shadow in the upper part of the anterior mediastinum is detected. The
presence of which of the following is the most likely cause?
A) goiter
B) the thymus gland
C) neuroblastoma
D) pericardial cyst
PED-4.375.
Which of the following is characteristic for the majority of neonatal
herpesvirus infections?
A) it is usually localized on the skin
B) no general symptoms are associated
C) it is caused by the type I virus
D) it might cause hepatitis
E) it is usually benign
PED-4.376.
Herpetic gingivostomatitis is not associated with:
A) fever
B) swelling of the gingiva
C) lymphadenopathy
D) ulceration of the oral mucosa
E) the development of papulous eruptions
PED-4.377.
The most common complication of varicella in childhood is:
A) pneumonia
B) encephalitis
C) cystitis
D) angioneurotic edema
E) a secondary bacterial infection of the skin
PED-4.378.
Which of the following is not characteristic for rubella?
A) eruptions occurring on the trunk
B) enlargement of the occipital and retroauricular lymph nodes
C) moderate fever
D) arthralgia
E) complicating pneumonia
PED-4.379.
Which of the following is characteristic for exanthema subitum?
A) the coxsackie virus has a role in the etiology
B) the disease lasts for 3-4 days, initially there is a high fever,
but the temperature normalizes following the occurrence of
the eruptions
C) just before the development of the eruptions the face looks
bruised
D) it is regarded as a non-infectious disease
E) when the eruptions disappear, hypopigmented areas may be
transiently observed
PED-4.380.
Characteristics of pyloric stenosis include all of the following, EXCEPT:
A) it is more frequent in boys
B) it is associated with projectile vomiting at the age of 4-8 weeks
C) it causes metabolic alkalosis
D) the diagnosis is confirmed by a barium meal (contrast media filling)
E) it must be differentiated from achalasia and hiatal hernia
PED-4.381.
All of the following statements concerning orthostatic albuminuria
are correct, EXCEPT:
A) most children exhibiting orthostatic albuminuria are healthy;
there is no underlying disease
B) albuminuria is detected when the patient is in a lying position
and it decreases after the patient stands up
C) renal functional tests are normal
D) the condition is usually diagnosed between the ages of 10-20 years
E) it is not associated with an increased risk of the development
of hypertension
PED-4.382.
All of the following diseases may cause hematuria in children, EXCEPT:
A) Wilms' tumor
B) minimal change disease (nephrosis syndrome)
C) polycystic kidney
D) subacute bacterial endocarditis
E) thrombosis of the renal artery
PED-4.383.
The most common cause of acquired hypothyroidism is:
A) cyanosis
B) thyroid carcinoma
C) lymphocytic thyroiditis
D) pituitary hypofunction
E) excision of the thyroglossal duct
PED-4.384.
All of the following statements about the sudden infant death syndrome
(SIDS) are correct, EXCEPT:
A) it is most frequently manifested between the ages of 2-5 months
B) the birth weight of the majority of the patients is low
C) its frequency is 4-7 times greater than the average infant mortality
rate
D) the number of cases has increased
E) the majority of the affected infants are boys
PED-4.385.
Which of the following is not characteristic for the fetal alcohol syndrome?
A) the increase of the height and weight are retarded, while head
E) the hairy skin of the affected area may hide small contusions
PED-4.392.
Case Study:
The physical examination of a newborn reveals respiratory insufficiency,
repleted cervical veins, low blood pressure, tympanic resonance
on one side of the chest, weak respiratory sounds and subcutaneous
emphysema on the same side. The most likely diagnosis is:
A) hyaline membrane disease
B) staphylococcal pneumonia
C) pneumothorax and pneumomediastinum
D) primary atelectasis
E) diaphragmatic hernia
PED-4.393.
A meconium plug is characteristic for which of the following diseases?
A) cretinism
B) cystic fibrosis
C) soor
D) hyaline membrane disease
E) trisomy 21
PED-4.394.
Conditions which may be associated with prolonged jaundice during
the first month of life include all of the following, EXCEPT:
A) cytomegalovirus infection
B) congenital biliary atresia
C) galactosemia
D) Rh-incompatibility
E) penicillin therapy
PED-4.395.
Characteristics of cretinism include all of the following, EXCEPT:
A) macroglossia
B) prolonged jaundice
C) lethargy
D) susceptibility to tetany
E) hypotension
PED-4.396.
In case of autosomal dominant inheritance, the inherited feature
would be manifested in one of the parents and in:
A) 50% of daughters and 75% of sons
B) 25% of sons and 75% of daughters
C) 50% of sons and 50% of daughters
D) the daughters only
E) none of the children
PED-4.397.
46 XY, 18q means, that:
A) the long arm of the 18th chromosome is missing in a boy
B) there is a translocation from the 18th chromosome to the Y
chromosome
C) the boy suffers from Klinefelter's syndrome
D) the boy suffers from Edwards' syndrome
E) this is the normal karyotype
PED-4.398.
Characteristics of Turner's syndrome (45 XO) include all of the following,
EXCEPT:
A) mental retardation
B) short stature
C) ovarian dysgenesis
D) primary amenorrhea
E) pectus excavatum
PED-4.399.
Edwards' syndrome is associated with all of the following, EXCEPT:
A) mental retardation
B) intrauterine atrophy
C) macrognathia
D) auricular deformities
E) congenital valvular heart disease
PED-4.400.
Case Study:
A 1-year-old girl cannot sit down without assistance. She is able to
take hold of objects with one hand but is unable to put them into the other
hand. She cannot climb or stand up. She can pronounce a few words, but shows no
interest for pictures. She does not respond very well to external stimuli.
What is your opinion about the somato-mental maturity of the child?
A) severe mental retardation
B) her maturity corresponds to the age of 11 months
C) her somatic maturity corresponds to the age of 6-8 months; a
moderate mental retardation is detected
D) her maturity corresponds to her age-group; no abnormality is
detected
PED-4.401.
Gastric lavage is contraindicated in case of intoxication with:
A) aspirin
B) alkali causing colliquation
C) diazepam (Seduxen)
D) castor oil
E) vitamins
PED-4.402.
Case Study:
A 4-year-old child experiences salicylate intoxication. The first
symptom is usually:
A) the development of petechiae and gingival hemorrhage
B) diplopia and peripheral blindness
C) hyperventilation
D) diarrhea and vomiting
E) the development of convulsions
PED-4.403.
Case Study:
An adolescent is transported to your office in a comatose state. The
pupils are narrow; the respiration is abnormal. Auscultation reveals
rales over the lung fields. The most likely diagnosis is:
A) bilateral bronchopneumonia
E) 50 IU
PED-4.410.
Symptoms of hypervitaminosis-D include all of the following, EXCEPT:
A) hypotension
B) polydypsia and polyuria
C) excitability
D) hypocalcemia
E) the calcification of tissues (kidney, vessel walls)
PED-4.411.
All of the following statements concerning the characteristics of
asthma in childhood are correct, EXCEPT:
A) the intrinsic form is more common than the extrinsic
B) type I asthma is characterized by an early hypersensitivity reaction
C) the IgE level is elevated
D) it is associated with the release of the slow reacting substance
of anaphylaxis (SRS-A)
E) the patient may be asymtomatic between the attacks
PED-4.412.
Characteristic alterations of circulatory volume and the circulatory
redistribution following birth are:
1) the blood volume relative to the body weight increases rapidly
during the first three months of life
2) the blood perfusion of the lung suddenly drops
3) the right ventricular stroke volume promptly increases
4) the pressure of the pulmonary artery rapidly decreases
PED-4.413.
Which of the following conditions are associated with a left to right
shunt?
1) patent ductus arteriosus (PDA)
2) atrial septal defect (ASD)
3) ventricular septal defect (VSD)
4) aortic-pulmonary fistula
PED-4.415.
Causative agents of a disease presenting with eruptions and symptoms
of serous meningitis are:
1) the rubella virus
2) the Hepatitis A virus
3) the Coxsackie A9 virus
4) the Echovirus 9
PED-4.416.
Possible causes of placental insufficiency include:
1) a very small placenta
2) early disruption of the placenta
3) large hemangiomas in the placenta
4) extensive infarction of the placenta
PED-4.417.
Possible causes of fetal anoxia include:
1) maternal carbon monoxide intoxication
2) maternal hypotension
3) placental insufficiency
4) tetany of the uterus
PED-4.418.
Possible causes of hypertension during childhood include:
1) glomerulonephritis
2) coarctation of the aorta
3) neuroblastoma
4) essential hypertension
PED-4.419.
It is important to realize that the technique of resuscitation is different
in children and adult patients. Which of the following considerations
concerning the anatomy of the infant or child may be important
during endotracheal intubation?
1) the epiglottis is shorter in the infant, and it has a U shape,
whereas in the adult it is longer and flat
2) the larynx is situated more anteriorly and cranially in infants
and children than in the adult
3) the angle of the epiglottis and the vocal cords is more sharp in
infants and children
4) the position of the heart is considerably higher in infants (it is
usually behind the mid-sternum), whereas in the adult it is
found behind the lower third of the sternum
PED-4.420.
Which of the following statements about the indications of operation
in congenital heart diseases are correct?
1) in the Tetralogy of Fallot an operation is indicated in each case
2) the most suitable time for the surgical correction of tricuspidal
atresia is after the age of 10 years
3) the optimal time for the correction of coarctation of the aorta is 2-5
years of age, except for cases with "critically severe coarctation of the aorta"
4) the optimal time for the surgery of a large ventricular septal
defect is at the age of 8-10 years
PED-4.421.
Five main aspects of the treatment of a child with diabetic
ketoacidosis are the management of hyperglycemia, dehydration,
acidosis, loss of electrolytes and the precipitating cause. What are
the steps in the therapy of diabetic ketoacidosis?
1) the subcutaneous administration of crystalline insulin in a 510 U/kg initial dose, then the hourly administration of insulin
until the blood glucose level reaches a normal range
glomerulonephritis?
1) unexpectedly urine becomes dark, a mild edema and a decreased
urine volume is detected
2) proper management of the streptococcal pharyngitis decreases
the frequency of nephritis by half
3) a strong hematuria usually relieves during the first week, but
microscopic hematuria may persist for two months
4) complete healing is predictable if the child survives the first
period
PED-4.440.
Characteristics of Klinefelter's syndrome include:
1) delayed puberty
2) gynecomastia
3) mental retardation and psychic abnormalities
4) aortic stenosis
PED-4.441.
Which of the following symptoms are indicative of Turner's syndrome
in infancy?
1) edematous hands and feet
2) a low birth weight
3) pterygium colli
4) a short stature
PED-4.442.
Amniocentesis helps the prenatal diagnosis of which of the following
conditions?
1) Down's syndrome
2) meningomyelocele
3) erythroblastosis
4) chondrodysplasia
PED-4.443.
Malformations associated with polyhydramnios include:
1) duodenal atresia
2) renal atresia
3) esophageal atresia
4) pulmonary hypoplasia
PED-4.444.
An ultrasound examination during pregnancy is suitable for:
1) the determination of the length of the fetus (crown-rump
length)
2) the determination of the sex of the fetus
3) the determination of the biparietal diameter of the skull
4) the exact determination of the weight of the fetus
CASE STUDIES
Answer the multiple task questions (simple choice and multiple choice
with/without key answers; relation analysis etc.) as they are related to
each case study!!!
PED-4.445.
Case Study
A 12-year-old girl's mother has repeatedly complained about her daughter's
PED-4.447
Case Study
A 4-year-old girl complained of abdominal pain the day before the examination.
She vomited once during the night. Her face is pale and
perioral cyanosis is seen. She has dyspnea and cough. Physical examination:
the stool is normal and the abdomen is bloated. The liver
exceeds the costal arch by 2 fingers. The spleen is not palpable. Respiratory
Case Study
A 4-week-old boy is brought to your office. His body temperature is no
mal, and he weighs 3,500 g. The infant has vomited after each meal for
3the last 5-6 days. No somatic growth has been seen during the last week.
4.450/ 1.
Which of the following questions have to be asked to complete the
history?
A) Is the quantity of the vomit large?
B) Does the infant vomit during feeding?
C) Did the parents note projectile vomiting or bilious vomit?
D) Does the infant accept mother's milk
4.450/2.
What is the most likely result of the examination?
A) it is unrevealing
B) cyanotic skin
C) resistance may possibly be detected on the right side of the
navel, peristaltic waves in the epigastrium
D) muscular hypotonia
4.450/3.
Which of the following laboratory results is most likely to be positive
in the condition?
A) metabolic alkalosis
B) negative urinalysis
C) a normal serum sodium concentration
D) negative renal functional tests
E) normal blood cell and differential counts
4.450/4.
Which of the following tests is useful to confirm the diagnosis?
A) pneumoencephalography
B) barium-swallow x-ray
C) native abdominal x-ray
D) basal and stimulated acid secretion of the stomach
E) intravenous urography
4.450/5.
Based on the above findings, the presumable diagnosis is:
A) salt-losing adrenogenital syndrome
B) aerophagia
C) hypertrophied pyloric stenosis
D) lack of belching after breastfeeding
E) inflammation of the central nervous system (meningitis, encephalitis)
4.450/6.
The therapy indicated in this condition is:
A) the administration of deoxycorticosterone acetate (DOCA)
B) a gastric lavage
C) frequent feeding with small quantities
D) the administration of spasmolytics
E) operation
PED-4.452.
Case Study
A 6-year-old girl is brought to your office. She voids turbid, dark red
colored urine and complains of dull lumbar pain. Her blood pressure
is 155/95 mmHg. Currently, the pharyngeal structures are normal.
She had pharyngitis associated with fever 3 weeks ago.
4.452/1.
A particularly imortant aspect of the physical examination is:
A) the neurologic status
B) auscultation of the lungs
C) a palpable resistance, which might possibly be present in the
abdomen
D) the detection of palpebral edema
4.452/2.
The most likely diagnosis is:
A) rheumatoid arthritis
B) nephrolithiasis
C) glomerulonephritis
D) renal tumor
4.452/3.
The most important additional test is:
A) a measurement of serum creatinine level
B) a urinalysis
C) a chest x-ray
D) a native abdominal x-ray
E) an ECG
4.452/4.
Which of the following is the most important therapeutic intervention
following admission to hospital?
A) the administration of spasmolytics
B) the administration of antibiotics
C) a salt- and protein-restricted diet
D) the administration of large quantities of fluid
PED-4.453.
Case Study
An 8-year-old girl develops eruptions following two days of subfebrility,
headaches and a loss of appetite. Maculo-papulo-vesicular lesions occur
on the trunk, on the hairy skin of the head, then on the whole
body surface of the body. Her body temperature is moderately elevated.
4.453/1.
The most likely diagnosis is:
A) erythema multiforme
B) generalized ekzema
C) herpes zoster
D) urticaria bullosa
E) varicella (chickenpox)
4.453/2.
The infecting microorganism is demonstrable in:
A) blood
B) stool
C) urine
D) vesicular content
E) sputum
4.453/3.
The incubation period of this disease is:
A) 2-3 days
B) 6 days
C) 2-3 weeks
D) 2 months
E) several months
4.453/4.
If no superinfection is present, the indicated therapy is:
A) tetracycline
B) erythromycin
C) prednisone
D) penicillin
E) none of the above
PED-4.455.
Case Study
A 6-year-old boy has been complaining of a sore throat and swelling of his
knees and ankles for a few days. He is admitted to a hospital because of severe
epigastric pain and blood in the stool. At admission: the ankles and feet are
moderately swollen and painful. Purpura is observed around the ankles and the
extensor surface of the legs. These are hemontiVc papules, surrounded by normal
skin. The abdominal examination reveals abnormalities. Amoderate anemia and
leukocytosis are detected. Urinalysis: microscopic hematuria. The blood pressure
is normal. Antistreptolysin titer. 800 U.
4.455/1.
The most likely diagnosis is:
A) rheumatoid arthritis
B) ulcerative colitis
C) Schonlein-Henoch purpura
D) rheumatic fever
E) acute glomerulonephritis
4.455/2.
The thrombocyte count found to be normal is of diagnostic value in
the following conditions:
1) rheumatic fever
2) rheumatoid arthritis
3) acute glomerulonephritis
4) Schonlein-Henoch purpura
A) (1), (2), and (3) are correct
B) (1) and (3) are correct
C) (2) and (4) are correct
D) only (4) is correct
E) all of the above
4.455/3.
The diagnosis, confirmed by the data, indicates penicillin administration,
because the disease is caused by staphylococcus.
A) both the statement and the explanation are true and a causal
4.456/2.
The most likely diagnosis is:
A) bronchopneumonia
B) congenital methemoglobinemia
C) acquired methemoglobinemia
D) cerebral arteriovenous fistula
E) congenital cardiac malformation with a right to left shunt
4.456/3.
Bronchopneumonia is excluded because bronchopneumonia in the
infancy can always be screened by the physical examination.
A) both the statement and the explanation are true and a causal
relationship exists between them
B) both the statement and the explanation are true but there is
no causal relationship between them
C) the statement is true, but the explanation is false
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false
4.456/4.
Congenital cardiac malformations are not always associated with
cyanosis because cyanosis is a sign of the accumulation of reduced
hemoglobin.
A) both the statement and the explanation are true and a causal
relationship exists between them
B) both the statement and the explanation are true but there is
no causal relationship between them
C) the statement is true, but the explanation is false
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false
4.456/5.
Acquired methemoglobinemia is a rare condition, because numerous
exogenous factors are capable of causing methemoglobinemia.
A) both the statement and the explanation are true and a causal
relationship exists between them
B) both the statement and the explanation are true but there is
no causal relationship between them
C) the statement is true, but the explanation is false
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false
PED-4.458.
Case Study
A 6-month-old infant is referred to the hospital by the physician. The
infant has been ill for 5 weeks. The disease started with the symptoms of
bronchitis and cough, for which penicillin therapy had been initiated.
After a transient improvement, the cough became more severe, and
subfebrility, then febrility developed. Following this, tetracycline
(Tetraolean) and penicillin had been administered in injection form.
These did not relieve the cough. The physical symptoms were characteristic for
bronchitis. Current symptoms: are loss of appetite, stagnation of somatic
growth, the stool is bulky, loose and fetid. Family history: the
parents mention that they lost their first child: she had an operation on
the 2nd day of her life and 3 days later she died. They remarked that:
"There was something wrong with her intestine".
4.458/ 1.
The most likely diagnosis is:
A) apiration pneumonia
B) gastroesophageal reflux
C) cystic fibrosis
D) ascariasis
E) interstitial plasmocytic pneumonia
4.458/2.
Which of the following diagnostic tests is the most important?
A) bronchography
B) chest x-ray
C) rectal digital examination
D) native abdominal x-ray
E) testing of the gastrointestinal passage
4.458/3.
Which of the following, additional tests would you order to confirm
your diagnosis?
A) the demonstration of worm eggs in the stool
B) liver biopsy
C) laryngoscopy
D) determination of the chloride concentration in the sweat
E) barium enema
4.458/4.
Which of the following additional tests is also useful?
A) an oral glucose tolerance test
B) determination of the enzyme activities in the duodenal fluid
C) an explorative laparotomy
D) a lung biopsy
E) abdominal ultrasound
4.458/5.
Based on the anamnestic data, which of the following drugs would
you order?
A) broad spectrum antibiotic
B) penicillin
C) trimethoprim-sulfamethoxazole (Sumetrolim)
D) metronidazole (Klion)
E) a strict diet; mucolytics; enzyme substitution
PED-4.459.
Case Study
A 6-year-old boy is brought to your office. Since 4-5 days ago, small
eruptions occurring on the entire body surface and blueish spots
of 2-10 cm in diameter in the lower extremities have been observed.
The boy's mother has not detected any alteration in the general
state of the child, his appetite and activity have been normal, although
two weeks ago the child had been febrile for a few days.
Physical examination: is unrevealing except for the skin lesions.
Liver and spleen are not palpable, lymph nodes are of normal size.
On the trunk and especially on the legs, (primarily on the areas
exposed to traumas) numerous ecchymoses, and pinhead sized
petechiae on the entire body are observed. Laboratory analysis:
4.462/6.
Which of the following therapeutic protocols would you choose for the
patient?
A) the subcutaneous administration of a combination of shortacting
and long-acting insulin
B) the frequent intravenous administration of short-acting insulin only
C) the frequent subcutaneous administration of short acting insulin only
4.462/7.
When ketonuria is not present, a single dose of insulin (by subcutaneous
injection) is:
A) 0.5 U/kg/24 h.
B) 0.25 U/kg/24 h.
C) 1.0 U/kg/2 h.
4.462/8.
Which of the following considerations concerning the insulin
therapy of a newly discovered diabetes in a patient with a clinically
sufficient general state are correct?
1) insulin is only administered intravenously
2) the administration of long-acting insulin, once daily, is indicated;
the number of units of insulin administered equals the age of
the child in years
3) the daily cumulative dose is 1 U/kg/24 h.
4) the daily cumulative dose is 0.1 U/kg/24 h.
5) short-acting insulin is administered subcutaneously, four times daily
A) (1), (2), and (3) are correct
B) (2) and (4) are correct
C) (1), (3), and (4) are correct
D) (3) and (5) are correct
E) (1) and (4) are correct
PED-4.464.
Case Study
A 4-week-old infant is brought to the physician by the mother. The mother
reports that the physiologic jaundice has never ceased completely. The
stool is greyish-white and the baby's urine stains the diaper brown. The
severity of the baby's jaundice soon increases.
4.464/1.
What is the most likely diagnosis?
A) sepsis
B) hepatitis
C) biliary tract atresia
4.464/2 .
The most informative laboratory test is:
A) a hemoculture
B) the RBC sedimentation rate; blood cell counts and the differential
count
C) a hepatic functional test
D) a renal functional test
E) a native abdominal x-ray
4.464/3.
4.465/3.
Which of the following diseases are associated with eosinophilia?
1) Hodgkin's disease
2) chronic granulocytic leukemia
3) scarlet fever
4) eosinophil granuloma
A) (1), (2), and (3) are correct
B) (1) and (3) are correct
C) (2) and (4) are correct
D) only (4) is correct
E) all of the above
4.465/4.
Which of the following conditions are characterized by more than
20% of atypical lymphocytes:
1) "post-transfusion syndrome"
2) cytomegalovirus infection
3) infectious mononucleosis
4) hepatitis A
A) (1),''(2), and (3) are correct
B) (1) and (3) are correct
C) (2) and (4) are correct
D) only (4) is correct
E) all of the above
4.465/5.
The disease the child has frequently leads to a chronic hepatic disorder,
because hepatic involvement is common in this disease.
A) both the statement and the explanation are true, and a causal
relationship exists between them
B) both the statement and the explanation are true, but there is
no causal relationship between them
C) the statement is true, but the explanation is false
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false
PED-4.467.
Case Study
You are called to a 14-month-old child. The child, following a period of mild
airway infection for a few days, developed fever, tachypnea, inspiratory
and occasionally expiratory dyspnea. Nostral flaring, synchronous
with the respiration, is pronounced. The child is moderately cyanotic.
Tympanic resonance is detected diffusely over the lungs, both coarse
and fine rates are audible. The white blood cell count is normal.
4.467/ 1.
What is the most likely diagnosis?
A) acute bronchopneumonia
B) acute bronchiolitis
C) bronchial asthma
D) essential pulmonary hemosiderosis
E) sepsis
4.467/2.
All of the following should be done to the child, EXCEPT:
A) the child has to be admitted to a hospital
breast aspirator
E) an infant with a cleft palate should be nourished with
squeezed milk from the mother
PED-4.471.
Characteristics of the Tetralogy of Fallot include:
A) a right deviation on the ECG
B) a wet lung
C) a loud second pulmonary sound
D) palliative surgical therapy includes an anastomosis between
the left subclavian and pulmonary arteries
E) a loud systolic murmur caused by the ventricular septal defect
PED-4.472.
Characteristic symptoms of acute poststreptococcal
glomerulonephritis include:
A) dehydration
B) a poor prognosis
C) facial edema
D) a low serum complement level
E) it usually occurs in children under the age of 4
PED-4.473.
Symptoms or signs, characteristic for hypertrophic pyloric stenosis
include:
A) bilious vomit
B) a lack of nervous plexuses in the pyloric wall
C) conjugated hyperbilirubinemia
D) a more frequent manifestation in boys than in girls
E) a palpable resistance in the abdomen
PED-4.476.
Characteristics of a mature 9-month-old infant are:
A) the infant grabs objects with the index and the thumb
B) the infant is able to drink from a glass without assistance
C) the infant is able to stand up with assistance
D) the infant follows simple commands
E) the infant can pronounce 6-10 words
PED-4.477.
A newborn exhibits spasmophilia. Relevant data of the history are:
A) the father suffers from glomerulonephritis
B) the mother received penicillin therapy during the first trimester
of her pregnancy
C) the newborn is nourished with cow's milk
D) fetal retardation
PED-4.478.
Non-articular manifestations of Still's disease (JRA) are:
A) bronchitis
B) eruptions
C) leukocytosis
D) splenomegaly
E) rheumatic nodules
PED-4.479.
E) Down's syndrome
PED-4.487.
Possible causes of jaundice in a neonate include:
A) hepatitis
B) ABO-incompatibility
C) congenital spherocytosis
D) gallstone disease
PED-4.488.
The most common causes of meningitis in a neonate are:
A) Staphylococcus aureus
B) Haemophilus influenzae
C) meningococcus
D) Streptococcus pneumoniae
PED-4.489.
Which of the following congenital cardiac malformations are associated
with cyanosis?
A) ventricular septal defect
B) atrial septal defect
C) Tetralogy of Fallot
D) transposition of the great arteries
PED-4.490.
A 2-year-old child is able to:
A) ride the bicycle
B) climb onto furniture
C) walk upstairs
D) recognize the parents
PED-4.491.
Which of the following have to be supplemented in a breastfed baby?
A) vitamin D
B) fluoride
C) iron
D) vitamin K
PED-4.492.
Which of the following infectious diseases do not need to be officially
reported?
A) scarlet fever
B) gastrointestinal salmonellosis
C) Hemophilus influenzae-meningitis
D) pertussis
E) herpes zoster
F) chicken pox
PED-4.493.
Which of the following non-infectious diseases have to be officially
reported?
A) developmental abnormalities
B) severe mental retardation
C) asthma
D) movement disabilities
E) chronic renal disease
PED-4.499.
Which of the following rules of ablactation are FALSE?
A) if milk production is sufficient, the ablactation is started during
the 2nd-3rd months
B) if milk production is sufficient, the ablactation is started during
the 6th month
C) the ablactation is started with supplementation of a food
preparation
D) the first sucking is replaced gradually over a period of 2-3
weeks, all the while adding increasing amounts of prepared
foods
E) the ablactation is started with a supplementation of potato and
carrot mash
PED-4.500.
An 8-month-old infant develops a mild iron deficiency. Which foods
do you recommend?
A) spinach
B) meat pure
C) liver
D) dairy products
PED-4.501.
All of the following are symptoms and complications of
hypervitaminosis-D, EXCEPT:
A) constipation
B) vomiting
C) loss of appetite
D) muscular hypertonia
E) hypercalcemia
F) hypokalemia
G) polydipsia and polyuria
H) renal failure
PED-4.502.
All of the following statements about vitamin C are correct, EXCEPT:
A) it plays a role in a number of enzymatic reactions
B) fresh fruits, especially lemons, oranges and grapefruit contain
considerable amounts of vitamin C
C) the requirements are increased in febrile diseases
D) a deficiency of vitamin C might cause pseudoparalysis
E) a deficiency of vitamin C might cause thrombocytopenic
purpura
F) the advisable supplementation of vitamin C for a child on an
average diet is 200 mg a day
PED-4.503.
All of the following statements about vitamin K are correct, EXCEPT:
A) it is a lipid soluble vitamin but a water soluble form also exists
B) it plays an essential role in the synthesis of coagulation factors
II, VII, IX and X
C) a lack of the intestinal flora may cause a vitamin K deficiency
D) hepatic disease may cause a vitamin K deficiency
E) if vitamin K is deficient, the first phase of coagulation is prolonged
F) in case of a hemorrhagic diathesis in a newborn, 10 mg of vitamin
K must be administered
PED-4.504.
Which of the following statements about kwashiorkor are correct?
A) kwashiorkor develops as a result of a protein-deficient and
carbohydrate-rich diet
B) in babies suffering from kwashiorkor, the Babinski reflex is
positive
C) hypoproteinemia is a characteristic finding
D) with time, symptoms of a deficiency of lipid soluble vitamins
develop
PED-4.505.
All of the following are possible causes of a loss of appetite, EXCEPT:
A) excess pampering
B) a lack of affection from the parents
C) a chronic disease
D) anemia
E) hyperthyroidism
F) a vitamin deficiency
G) gastric hyperacidity
PED-4.506.
Which of the following considerations are important in the treatment
of exogenous obesity? .
A) the child has to be separated from the family for a long period
B) the physician needs the assistance of the parents as well
C) the caloric intake should not exceed 3,700-4,200 kJ
D) refined sugar should be strongly restricted
E) anorexigenic drugs are advisable from the age of 4
F) additional psychotherapy is needed
PED-4.508.
All of the following statements concerning potassium replacement
are correct, EXCEPT:
A) the value of the serum potassium concentration and the volumes
of body fluid compartments are not enough for a proper
estimate of the magnitude of the potassium depletion
B) intracellular potassium depletion may roughly be estimated by
ECG abnormalities
C) in hypokalemia, the QT interval is shorter on the ECG
D) potassium depletion is severe in hyponatremic dehydration
and diabetic ketoacidosis
E) a parenteral potassium replacement in a form of an infusion
must be controlled by the detection of the serum potassium
concentration and an ECG
F) 1 ml of 10% KCl solution contains 1 mmol of potassium
PED-4.509.
Which of the following statements about fructose intolerance are correct?
A) symptoms develop following the first suckling
B) tea sweetened with glucose elicits vomiting
C) tea sweetened with saccharose elicits vomiting
D) symptoms are caused by hyperglycemia
E) fructose is detectable in the urine following the consumption
of tea sweetened with saccharose
PED-4.511.
PED-4.530.
Symptoms and features of a patent ductus arteriosus during infancy
include all of the following, EXCEPT:
A) an increased right ventricular afterload is detected
B) the diastolic pressure is normal
C) a systolic murmur is audible in the left 2nd intercostal space
D) a prolonged bronchitis may cause obstruction
E) the ECG reveals signs of left ventricular hypertrophy
PED-4.531.
Which of the following statements concerning a patent ductus
arteriosus are correct?
A) a systolic-diastolic murmur is detected
B) most cases discovered during the neonatal period require surgery
C) a fluctuating pulse
D) in all cases of combined anomalies; the patent ductus must be
closed by drugs or by surgical correction
PED-4.532.
Which of the following congenital heart diseases are associated with
a left to right shunt?
A) Tetralogy of Fallot
B) pulmonary atresia
C) patent ductus arteriosus
D) endocardial cushion defect
E) tricuspidal atresia
F) coarctation of the aorta
G) large ventricular septal defects
H) transposition of the great arteries
I) abnormal origin of the coronary arteries
PED-4.533.
What are the clinical symptoms of a severe ventricular septal defect
in a 2-year-old child?
A) a loud holosystolic murmur audible in the left 3rd-4th intercostal
space
B) an isolated left ventricular hypertrophy
C) the oxygen saturation of the blood in the two ventricles is
identical
D) recurrent respiratory tract infections; pneumonias
E) protrusion of the cardiac region
PED-4.534.
Determine five specific manifestations of rheumatic fever from the
list below!
A) fever
B) carditis
C) arthralgia
D) polyarthritis
E) chorea minor
F) an increased red blood cell sedimentation rate
G) the development of subcutaneous nodules
H) erythema annulare
I) erythema multiforme
PED-4.535.
PED-4.555.
In which of the following conditions is iron replacement not indicated?
A) hemolytic anemia
B) hemorrhagic anemia
C) thalassemia beta minor
D) infections
E) hemosiderosis
PED-4.556.
Case Study:
Your patient exhibits pallor and strong dyspnea. The results of the
available biochemical tests are: hemoglobin 2.5 mmol/l, hematocrit
14%, reticulocyte count 2000/00. Which of the following possibilities
would you consider to further investigate?
A) leukemia
B) panmyelopathy
C) hemolytic anemia
D) severe iron deficiency
E) hemorrhagic anemia
PED-4.557.
Which of the following conditions are possible causes of a
hypoplastic anemia?
A) premature delivery
B) uremia
C) hypothyroidism
D) infections
E) iron deficiency
PED-4.558.
Case Study:
Splenectomy is a possibile therapeutic intervention for a 3-year-old
child suffering from congenital spherocytosis. Which of the following
considerations about the proposed operation are correct?
A) the patient should undergo the operation as soon as possible;
as this would considerably decrease hemolysis
B) it is advisable to wait for one more year until the operation
C) a splenectomy predisposes for fulminant bacterial infections
D) Streptococcus pyogenes is the most common microorganism
causing infections after the operation
E) prophylactic penicillin administration is indicated for one year
following a splenectomy
PED-4.559.
Which are the possible factors predisposing to the development of
methemoglobinemia caused by a high nitrate concentration in the
drinking water?
A) the young age of the infant
B) a premature delivery
C) trauma at birth
D) dyspepsia
E) oliguria
PED-4.560.
Which of the following statements about Schnlein-Henoch purpura
are FALSE?
A) it is associated with maculo-papulous and later, purpura-like
eruptions
B) swelling of the joints lasts for 1-2 months
C) it may be associated with abdominal pain caused by the edema
or hemmorrhage of the intestinal wall
D) the occurrence of a microscopic hematuria suggests renal involvement
E) the disease lasts for years even in uncomplicated cases
PED-4.561.
Which of the following guidelines for the therapy of acute
lymphoblastic leukemia are FALSE?
A) the initial step is intensive drug therapy of 4-5 weeks duration
B) the intensive phase is followed by active chemotherapy
C) meningeal prophylaxis is carried out with irradiation of the
central nervous system because it is unresponsive to
cytostatics
D) in some cases, the intensive therapy is repeated 2 months later
E) maintenance therapy is discontinued every 1-2 months by
reinductions of 1 week duration
F) the chemotherapy lasts for 5 years in each case
PED-4.562.
Which of the following interventions are suitable for the prevention
of leukemic meningiosis?
A) regular intravenous cytostatic therapy
B) frequent blood transfusions
C) immunostimulants
D) craniospinal irradiation
E) methotrexate (intrathecally)
PED-4.563.
Which of the following statements about the healing of acute
lymphoblastic leukemia are correct?
A) symptomless long term survival is expectable in 70-80% of the
cases with a good prognosis and in 50% of the cases with a
poor prognosis
B) only 1-2% of long term survivors develop late relapse
C) approximately half of the patients with late relapse can be
healed by repeating the therapy
D) the development of a second malignancy is more frequent
among those who recovered from leukemia than in the general
population
E) the occurrence of malignancies among the offspring of leukemic
patients is more frequent than in the general population
F) bone marrow transplantation is a possible therapeutic intervention
in case of a late relapse
PED-4.564.
Which of the following malignancies are the most frequent during
the childhood?
A) Ewings sarcoma
B) cerebral tumor
C) lung cancer
D) primary hepatocellular carcinoma
E) leukemia
PED-4.575.
The presence of which of the following symptoms is necessary for
the diagnosis of diabetes mellitus?
A) glycosuria
B) hyperglycemia, (other possible causes excluded)
C) ketonemia
D) ketonuria
E) metabolic acidosis
PED-4.576.
Case Study:
A) 7-year-old, moderately desiccated child is brought to your office
with symptoms of acidotic respiration, polyuria and glycosuria. The
blood glucose is 17 mmol/1, pH: 7.22. The condition requires all of
the following interventions, EXCEPT:
A) the immediate infusion of half-physiologic saline containing
5% glucose
B) the immediate infusion of physiologic saline
C) crystalline insulin, initially 0.l-0.2 U/kg iv., then smaller
doses in infusion, later subcutaneously, as needed
D) fluid intake during the first day should be 3-4 l/mz body
surface
E) bicarbonate is administered until the pH is completely normalized
PED-4.577.
Which of the following statements about hypoglycemia in a diabetic
patient are correct?
A) symptoms develop slowly
B) thirst and flush on the face are characteristic
C) convulsions may develop
D) sugar-free drinks should be administered
E) a heavy physical excercise may precipitate hypoglycemia
PED-4.578.
Along with the precise therapy of diabetes mellitus, which of the following
aims are also reasonable?
A) to prevent the development of polyuria, polydipsia and
polyphagia
B) to maintain a normal lifestyle and development
C) to maintain a continuous normoglycemia
D) to maintain a low HbA1c level
E) to prevent the development of microangiopathy lifelong
PED-4.579.
Which of the following diseases are characterized by polyuria?
A) untreated diabetes mellitus
B) renal glucosuria
C) nephrogenic diabetes insipidus
D) hyperkalemia
E) renal tubular acidosis, distal type
PED-4.580.
Which of the following diseases can be diagnosed with the help of
intravenous urography?
A) morphological, situational and cavital abnormalities of the kidneys
and the urinary tract
PED-4.591.
Which of the following statements concerning abnormalities of closing
of the neural tube are FALSE?
A) it is an isolated malformation, affecting the development of one
organ only in the majority of cases
B) in all cases of myelomeningocele, the neural tissue in the affected
area is damaged
C) spina bifida aperta requires a careful neurological examination
within 24 hours after birth
D) anomalies of the closing of the neural tube are diagnosed in
the late phase of pregnancy when it is too late for induced
abortion, so there are no screening tests suitable for the early
detection of the condition
PED-4.592.
Which of the following do not belong to the neonatal primitive reflexes?
A) tonic symmetrical and asymmetrical reflexes
B) Moro's reflex
C) Gordon's reflex
D) Landau reflex
E) grasping reflex
F) patellar reflex
PED-4.593.
Which of the following diseases are associated with alterations of the
cerebrospinal fluid?
A) Guillain-Barr syndrome
B) diabetic coma
C) herpesvirus-meningoencephalitis
D) epilepsy
E) encephalopathy caused by diphtheria-pertussis-tetanus (DPT)
immunization
PED-4.594. All of the following drugs are suitable for the treatment of cerebral
edema, EXCEPT:
A) 2% glycerine and 10% NaCl solution intravenously
B) phenobarbital
C) mannitol
D) furosemide (Furosemid)
E) 20% glucose solution
PED-4.595.
Which of the following statements about absence epilepsy in childhood
are FALSE?
A) it is accompanied by a loss of consciousness for a few seconds
B) spike discharges with 3/s frequency in the EEG are typical
C) it responds well to drug therapy
D) it usually affects mental development
E) with time, 5-6% of these cases develop grand mal seizures
F) valproate is an effective therapeutic agent
PED-4.596.
The most frequent symptoms of a cerebral tumor in infancy include
all of the following, EXCEPT:
A) headache
B) vomiting
C) papillary edema
D) spasms
E) disruption of the sutures
PED-4.597.
All of the folowing are symptoms of the chronic organic
psychosyndrome in childhood, EXCEPT:
A) indiscriminate behavior
B) indifferent affection, insensibility
C) a loss of concentration
D) hypermotility
E) good manual skills
F) variable performance
PED-4.598.
The most severe environmental damage that a child can experience
is the separation from the mother and family. Which of the following
statements concerning this are correct?
A) the severity of the damage depends on the mother's replacement's
capacity
B) the consequences of the damage, if the separation happened during
infancy, can still be eliminated totally by the age of 4-5 years
C) symptoms of institutilization are: stereotypic movements, genital
manipulations, mental and emotional abnormalities
D) the development of the motor system during confinement is
undisturbed
E) the emotional injury does not affect the somatic development
PED-4.599.
Which of the following conditions are possible causes of
oligophrenia?
A) hypoxic damage
B) metabolic disorder
C) genetic factors
D) hypothyroidism
E) encephalitis
F) lupus erythematosus
G) mumps meningitis
PED-4.600.
Which of the following statements concerning congenital dislocation
of the hip or hip joint dysplasia are correct?
A) the inheritance pattern is autosomal dominant
B) an x-ray screening test is advisable at the age of 3 weeks and it
is compulsory at the age of 4 months
C) in case of real luxation, the articular head is repositioned with
abduction of the extremity
D) the femoral head can be luxated in case of an unstable hip
joint
PED-4.601.
In which of the following conditions are the nervous system symptoms
caused by the penetration of the microorganism into the CNS?
A) diphtheria
B) tetanus
C) poliomyelitis
D) epidemic meningitis
E) . botulism
PED-4.603.
An individual may have scarlet fever several times during his lifetime.
Which of the following statements explain this phenomenon?
A) the different erythrotoxins produced by Streptococcus
pyogenes have different antigen properties, therefore the antitoxic
immunity induced by a given toxin would not protect
against another
B) the toxin produced by Streptococcus pyogenes is not an antigen,
therefore immunization against it is impossible
C) the early penicillin therapy of the infection diminishes
erythrotoxin production so it is insufficient to elicit an antitoxin
production
D) scarlet fever is caused by a variety of viruses, between which
no cross-immunity exists
PED-4.604.
Case Study:
In Hungary, which of the following interventions is required for the
therapy of scarlet fever in a 3-year-old child?
A) 2x1 tablet Vegacillin for 10 days (1 tablet contains 200,000 IU Vpenicillin)
B) 3x1 tablet Maripen for 6 days (1 tablet contains 500,000IU G-penicillin)
C) if oral therapy is not feasible (vomiting, unreliable parents),
Retardillin irn once daily for 6 days (500,000 IU G-penicillin+procaine)
D) 3x2 tabl. Maripen for 8 days
E) 100,000 IU/kg/day crystalline penicillin, divided into 4 doses
a day, for 10 days
PED-4.605.
In which of the following cases of salmonella infection would you
order antibiotics?
A) salmonella- gastroenteritis in a 5-year-old, otherwise healthy child
B) salmonella-gastroenteritis in a 5-day-old, otherwise healthy newborn
C) Salmonella typhi infection, causing symptoms, at any age
D) salmonella sepsis of a granulocytopenic child
E) a purulent meningitis caused by salmonella
PED-4.606.
Which of the following statements concerning measles are correct?
A) the incubation period is 2 weeks
B) the incubation period is shorter in case of partial immunity
C) eruptions develop 4 days after the onset of symptoms
D) the disease is infectious until the end of the furfuraceous
desquamation
E) measles virus infection has a transient immunosuppressive effect
PED-4.607.
Which of the following statements about the eruptions observed in
measles are correct?
A) the eruptions first develop on the extremities, then on the trunk
B) the face is never affected
C) the characteristic eruptions first occur behind the ear and on
the face, then spread to the trunk. and to the extremities
F) Klebsiella
PED-4.613.
Which of the following statements concerning purulent meningitis in
an infant younger than 3 months are correct?
A) the most frequent cause is E. coli
B) the disease is always associated with high fever
C) stiff fontanelles associated with the refusal of food and repeated
vomiting might call the physician's attention to the disease
D) papilledema is pathognomonic for the condition
E) microscopic examination of the cerebrospinal fluid sediment
clarifies the etiology in each case
PED-4.614.
Which of the following microorganisms are the most frequent causes
of purulent meningitis during childhood in Hungary?
A) Neisseria meningitidis
B) Streptococcus pneumoniae
C) Haemophilus influenzae
D) Group B streptococcus
E) Streptococcus pyogenes
F) E. coli
G) Staphylococcus aureus
PED-4.615.
Before having the bacteriology results, which of the following drugs
or drug combinations are suitable for the presumptive therapy of a
purulent meningitis in a young child?
A) penicillin
B) ampicillin and gentamicin
C) ampicillin and chloramphenicol
D) tetracycline and sulphonamide
E) ceftriaxone (Rocephin)
PED-4.616.
Which of the following statements about tetanus are correct?
A) the toxin exerts its effect in the synapses
B) the incubation period is l-2 days
C) mental confusion develops usually
D) a lumbar puncture relieves the spasm
E) since the causative microorganism is anaerobic, metronidazole
or clindamycin are the drugs of choice
F) human tetanus immunoglobulin is administered for the neutralization
of the circulating toxin
PED-4.617.
Which of the following conditions may be associated with Lyme's
disease?
A) megalerythema infectiosum
B) chronic rheumatoid arthritis
C) carditis
D) prolonged diarrhea
E) chronic erythema migrans
F) tick-borne meningoencephalitis
G) isolated facial nerve paralysis (Bell's type)
H) persistent fever of unknown origin
PED-4.618.
In which of the following conditions is neonatal BCG vaccination
CONTRAINDICATED?
A) diabetes mellitus of the mother
B) perinatal cerebral injury
C) pyoderma
D) congenital immune deficiency of the sibling
E) a birth weight of under 2,500 g
PED-4.619.
Which of the following statements concerning vaccinations are
FALSE?
A) hemophilic patients receive all of the compulsory vaccinations;
parenteral vaccinations have to be supplemented with the administration
of clotting factors
B) a child suffering from von Willebrand's disease should not be
vaccinated against measles
C) a thrombocytopenic child should be vaccinated against measles
only after receiving prophylactic platelet concentrate treatment
D) vaccination with live, attenuated virus to children receiving
cytostatic therapy is usually contraindicated
E) leukemic patient in the remission phase can be vaccinated
with tetanus toxoid
PED-4.620.
Which of the following intoxications are associated with myosis?
A) antihistamines
B) morphine derivatives
C) organic phosphate esters
D) diphenoxylate (Reasec)
E) cocaine
F) neostigmine (Prostigmin)
PED-4.621.
Which of the following intoxications are associated with jaundice?
A) lead
B) Amanita phalloides
C) carbon tetrachloride
D) organic phosphate esthers
E) nitrobenzole
PED-4.622.
Which of the following intoxications may cause convulsions?
A) aminophenazone (Amidazophen)
B) antihistamines
C) theophylline
D) organic phosphate esthers
E) Amanita phalloides
F) codeine
PED-4.623.
In which of the following intoxications is gastric lavage
CONTRAINDICATED?
A) narcotics
B) hydrocarbons (gasoline, petroleum)
C) Amanita phalloides
D) acid; alkali
E) salicylates
PED-4.624.
What has to be done to a patient with suspected barbiturate intoxication
in a hospital department?
A) gastric lavage
B) intestinal irrigation
C) the subcutaneous administration of epinephrine
D) forced diuresis
E) the intravenous administration of nalorphine
F) artificial respiration
G) dimethyl-glutarimide (Redimyl)
PED-4.625.
Which of the following statements concerning toxicomania are correct?
A) the sense of the term narcomania is broader than that of toxicomania
B) toxicomania is an intoxication with a narcotic or some substance
which elicits a stimulative or hallucinogenic effect
C) irresistible addiction is a characteristic feature
D) the patient needs the same doses continuously
E) the patient develops total dependence to the drug
PED-4.626.
Case Study:
You are examining a 4-year-old, child having 39C fever. The general
state of the child is sufficient. The physical examination is
unrevealing except for a mildly hyperemic pharyngeal mucosa.
Which of the following therapeutic possibilities would you choose?
A) 1/2 tabl. aspirin (1 tablet contains 0.45 g acetylsalicylic acid)
every four hours or 0.15 g aminophenazone
B) if the relief of fever is insufficient the above dose is doubled
C) if the relief of fever after the first dose is insufficient, a
Priessnitz compress is needed one time only
D) if the relief of fever after the first dose given in point (A) is
insufficient, a Priessnitz compress is needed, once every 10 minutes,
until the temperature decreases to under 38C
E) antibiotic therapy is started
PED-4.627.
Which of the following conditions, associated with airway obstruction,
are life-threatening?
A) laryngitis subglottica (pseudocroup)
B) acute epiglottitis
C) acute, dry laryngo-tracheobronchitis
D) acute rhinopharyngitis
E) none of the above
PED-4.628.
The rapid relief of hypertension is possible with all of the following
drugs, EXCEPT:
A) diazoxide
B) nitroprusside
C) hydralazine
D) vinpocetine (Cavinton)
E) chlorpromazine (Hibernal)
F) phentolamine (Regitin)
PED-4.629.
Symptoms of hypovolemic shock include all of the following, EXCEPT:
A) pallor and cold extremities
B) agitation, followed by drowsiness
C) tachycardia
D) a low central venous pressure
E) cardiac enlargement
F) acidosis
G) a decreased arterio-venous oxygen difference
PED-4.630.
Which of the following steps of the first aid of a burn injury are INCORRECT?
A) immediate cooling with cold water, even with the clothes on
B) clothes covering the burned area have to be removed after
cooking
C) cooking oil is spread over the wounds and it is covered with a
sterile bandage
D) the wound has to be powdered with vulnerary powder and covered
with a sterile bandage
E) the wound is covered loosely with sterile gaze
F) pain relievers and sedatives are administered
G) the patient is immediately referred to a burn centre
PED-4.631.
Which of the following statements concerning the estimation of the
severity of a burn injury are correct?
A) only the epithelial layer is damaged in first degree burns
B) the total dermis and the appendages are damaged in second
degree burns
C) in case of third degree burns, the skin of the affected area is
damaged in its total thickness, regeneration is only possible
from the intact, surrounding skin; in case of extensive burn
the only possibility for healing without deformities is a skin
transplantation
PED-4.632.
Which of the following statements concerning auditory disturbances
are correct?
A) in the case of conductional auditory disturbances, abnormalities
are observed in the external, middle and internal ear
B) in case of sensory neural auditory disturbances, abnormalities
occur in the acoustic nerve, auditory path and in the sensory
cortical area
C) objective audiometry can also be performed in infancy
D) bradyacusia in infancy does not need to be corrected with a
hearing aid
E) auditory tests are advisable from the neonatal period until the
age of 17 years
PED-4.633.
Which of the following statements characterizing atopic dermatitis
are correct?
A) it affects approximately 3% of the child population
B) isoniazid
C) neomycin
D) cyclophosphamide
E) ferrous sulphate
F) phenobarbital
ASSOCIATION QUESTIONS
Associate the following terms/statements marked by the letters
A, B, C... with the corresponding statements/terms marked by and in
the order given by the figures 1, 2, 3...
...for example: 1-C, 2-B, 3-A, 4-D. Put the answer as C, B, A, D!
(Note: Different statements can be associated with the same terms!!!)
PED-6.644.
Associate the following term(s) with their corresponding statement(s)!
A) Cyanides
B) Narcotics
C) Both of the above
D) None of the above
1) methylene blue is an antagonist or chelator of these poisons
2) atropine sulphate is an antagonist or chelator of these poisons
3) naloxone (Narcan) is an antagonist or chelator of these poisons
4) amylnitrite, sodium nitrite and sodium thiosulphate are antagonists
or chelators of these poisons
5) the antidote to these poisons may have to be given repeatedly
to elicit the effect
PED-6.645.
Associate the following term(s) with their corresponding statement(s)!
A) Immunization against measles
B) Immunization against German measles
C) Both of the above
D) None of the above
1) as a routine immunization, it is not advisable to administer
before the age of 15 months
2) administration is contraindicated during pregnancy
3) it might cause arthritis or peripheral neuritis within 70 days
following the immunization
4) fever and eruptions may develop 6-10 days after the immunization
5) it should not be given in combination with other virus vaccines
due to virus interference problems
PED-6.646.
Associate the following term(s) with their corresponding statement(s)!
A) Trichophyton tonsurans
B) Microsporum cants
C) Both of the above
D) None of the above
1) it causes a mycosis of the hairy skin of the head
2) it causes a fungal vaginitis following puberty
3) it is usually fluorescent under Wood's lamp
4) it causes vaginal itching and a watery discharge
5) short, fragmented hair is strongly suggestive of the infection
PED-6.648.
Associate the following term(s) with their corresponding statement(s)!
A) Vitamin A) deficiency
B) Vitamin B1 deficiency
C) Vitamin B6 deficiency
D) Vitamin C deficiency
E) Vitamin D deficiency
F) Vitamin K deficiency
1) spasms may occur
2) gingival hemorrhage
3) sluggish tendon reflexes
4) dry and hyperkeratotic skin
PED-6.649.
Associate the following statement(s) with their corresponding term(s)!
... in terms of dietary treatmentfor the disorder
A) a diet containing medium chain fatty acids
B) oral supplementation of zinc sulphate
C) a gluten-free diet
D) a flour and starch-free diet
E) a galactose (lactose-) free diet
F) a lactose (sucrose-) free diet
1) Celiac disease
2) Congenital sucrose-isomaltase defect
3) Intestinal lymphangiectasis
4) Galactosemia
5) Postenteritic malabsorption
6) Acrodermatitis enteropathica
PED-6.650.
Associate the following term(s) with their corresponding statement(s)!
A) Inspiratory dyspnea
B) Expiratory dyspnea
C) Both of the above
D) None of the above
1) epiglottitis
2) bronchial asthma
3) laryngitis subglottica
4) pertussis, during a crisis
PED-6.651.
Associate the following term(s) with their corresponding statement(s)!
A) IgA
B) IgD
C) IgE
D) IgG
E) IgM
1) the primary immune response
2) the passive immunity of neonates
3) the secretory defense of the mucosal surfaces
PED-6.663.
Associate the following term(s) with their corresponding statement(s)!
A) Hepatitis A virus
B) Hepatitis B virus
C) Hepatitis C virus
D) Hepatitis D virus
E) Hepatitis E virus
1) it is usually acquired parenterally
2) it is actually a parasitic RNA virus
3) it has caused a high mortality rate in pregnant women
4) antibody of this virus appears within 1-4 weeks of clinical
symptoms
5) transmission is by the fecal-oral route
6) antibodies to this newly isolated virus may not appear for up
to six months
7) this DNA virus is referred to as the Dane particle
PED-6.664.
Associate the following term(s) with their corresponding statement(s)!
... in terms of a latent iron deficiency
A) Normal value
B) Decreased value
C) Elevated value
1) hemoglobin
2) serum iron
3) total iron binding capacity (TIBC)
4) iron saturation of transferrin
5) hematocrit
6) serum ferritin
7) iron absorption (no malabsorption is present)
8) number of sideroblasts in the bone marrow
Answer Key
(PED-4)
1.2.D
3.C
4.5.6.A
7.C
8.A
9.C
10.D
11.A
12.E
13.D
14.C
15.D
16.C
17.E
18.A
19.D
20.C
21.C
22.D
23.E
24.A
25.C
26.C
27.D
28.D
29.A
30-C
31.B
32.C
33.A
34.C
35.E
89.D
90.D
91.D
92.B
93.C
94.E
95.B
96.D
97.C
98.B
99.C
100.D
101.B
102.F
103.D
104.D
105.D
106.D
107.D
108.D
109.F
110.A
111.D
112.D
113.C
114.D
115.D
116.C
117.D
118.C
119.C
120.B
121.C
122.D
123.D
177.D
178.C
179.B
180.D
181.E
182.A
183.C
184.E
185.B
186.E
187.B
188.E
189.B
190.C
191.E
192.B
193.C
194.B
195.B
196.C
197.D
198.C
199.D
200.B
201.C
202.C
203.C
204.D
205.D
206.A
207.A
208.D
209.C
210.C
211.C
265.C
266.B
267.B
268.B
269.E
270.D
271.C
272.A
273.D
274.A
275.D
276.C
277.E
278.C
279.D
280.E
281.B
282.A
283.D
284.B
285.D
286.F
287.E
288.E
289.E
290.D
291.C
292.E
293.D
294.A
295.B
296.C
297.C
298.D
299.D
353.A
354.355.B
356.F
357.C
358.B
359.E
360.A
361.A
362.A
363.C
364.D
365.E
366.D
367.D
368.C
369.D
370.D
371.C
372.A
373.B
374.B
375.D
376.E
377.E
378.A
379.B
380.D
381.B
382.B
383.C
384.D
385.A
386.D
387.B
441.E
442.A
443.B
444.B
445.BCDE
446.CDC
447.CCBD
448.449.CACBD
450.CCABCE
451.452.DCBC
453.EDCE
454.455.CDCEB
456.ACCBD
457.458.CBDBE
459.ACCBC
460.DCAE
461.462.CBAEBBBD
463.464.CCCCA
465.DEAAD
466.467.BE
468.AD,ABE
469.AC
470.AB
471.AD
472.CD
473.DE
474.475.-
529.BD
530.BC
531.AC
532.CDG
533.ADE
534.BDEGH
535.BE
536AC
537.DG
538.BDE
539.DF
540.CE
541.AD
542.CD
543.AD
544.BC
545.BF
546.DE
547.ADE
548.CE
549.ADC
550.AB
551.AC
552.AC
553.AD
554.AEF
555.ACDE
556.CE
557.ABCD
558.BCE
559.ABD
560.BE
561.CF
562.DE
563.ADF
617.BCEFGH
618.CDE
619.BC
620.BCDF
621.BCE
622.ACD
623.BD
624.ABDFG
625.BCE
626.AD
627.ABC
628.DE
629.EG
630.CD
631.AC
632.CE
633.ABD
634.ADE
635.CD
636.ACDE
637.CDEG
638.BC
639.ADEF
640.ACF
641.AEF
642.AF
643.CEF
644.DDBAB
645.CCBAD
646.CDBDC
647.648.CDBA
649.CDAEFB
650.ABAA
651.EDAC
36.E
37.C
38.D
39.D
40.C
41.D
42.B
43.D
44.C
45.C
46.B
47.B
48.C
49.B
50.A
51.B
52.A
53.A
54.A
55.A
56.E
57.A
58.B
59.B
60.61.A
62.B
63.C
64.B
65.A
66.C
67.E
68.E
69.B
70.A
71.C
72.C
73.A
74.A
75.B
76.77.D
78.D
79.C
80.D
81.C
82.A
83.E
84.C
124.E
125.D
126.C
127.A
128.A
129.B
130.C
131.D
132.B
133.E
134.E
135.D
136.C
137.B
138.D
139.D
140.C
141.D
142.E
143.E
144.D
145.D
146.C
147.C
148.D
149.C
150.D
151.D
152.E
153.154.D
155.D
156.C
157.D
158.C
159.A
160.D
161.D
162.E
163.B
164.D
165.C
166.A
167.B
168.D
169.C
170.B
171.C
172.C
212.E
213.E
214.A
215.C
216.D
217.C
218.D
219.E
220.C
221.D
222.A
223.B
224.C
225.226.C
227.D
228.B
229.C
230.D
231.C
232.C
233.A
234.B
235.E
236.D
237.B
238.B
239.C
240.F
241.C
242.F
243.D
244.D
245.D
246.C
247.E
248.C
249.E
250.D
251.C
252.C
253.D
254.G
255.F
256.A
257.C
258.A
259.C
260.H
300.D
301.B
302.C
303.304.C
305.C
306.E
307.C
308.D
309.B
310.B
311.A
312.B
313.B
314.C
315.H
316.B
317.B
318.B
319.C
320.A
321.E
322.C
323.B
324.C
325.E
326.D
327.D
328.C
329.B
330.B
331.B
332.D
333.A
334.C
335.D
336.E
337.B
338.C
339.C
340.E
341.C
342.D
343.F
344.D
345.D
346.E
347.E
348.E
388.C
389.B
390.A
391.D
392.E
393.B
394.E
395.D
396.C
397.A
398.A
399.C
400.C
401.B
402.C
403.B
404.E
405.E
406.E
407.A
408.E
409.B
410.D
411.A
412.D
413.E
414.415.D
416.D
417.D
418.E
419.A
420.A
421.C
422.423.424.425.B
426.E
427.A
428.B
429.E
430.A
431.A
432.A
433.E
434.435.436.E
476.AC
477.CD
478.BCD
479.ABE
480.481.AE
482.AB
483.CE
484.BC
485.ABDE
486.ACD
487.ABC
488.BD
489.CD
490.BCD
491.ABD
492.CEF
493.ABDF
494.FG
495.AD
496.ADEF
497.BC
498.AF
499.AC
500.ABC
501.DF
502.EF
503.EF
504.ACD
505.EG
506.BCDF
507.508.CF
509.CE
510.511.ACD
512.ABCD
513.AE
514.AC
515.BCE
516.AE
517.DE
518.BE
519.CD
520.ABC
521.ACE
522.ACDEF
523.AD
524.CD
564.BE
565.ABE
566.DF
567.AE
568.BCD
569.AB
570.DE
571.CE
572.ABC
573.AC
574.CD
575.AB
576.AF
577.CE
578.ABD
579.ACE
580.AD
581.CE
582.BDEH
583.AF
584.CD
585.AD
586.ADE
587.CD
588.ABD
589.ABE
590.AB
591.AD
592.CF
593.ABCF
594.AE
595.DE
596.AC
597.BE
598.AC
599.ABCDE
600.CD
601.CD
602.603.AC
604.BC
605.BCEF
606.CE
607.CE
608.CDF
609.ADF
610.611.DF
612.BD
652.653.ABAA
654.BACAED
655.EABDCA
656.CADDD
657.BDAAC
658.DDDBA
659.BCDAE
660.CADEB
661.BADAC
662.DAAABC
663.BDEAACB
664.ABCBABCB
85.C
86.E
87.C
88.A
173.C
174.C
175.A
176.E
261.C
262.A
263.F
264.B
349.G
350.C
351.A
352.B
437.A
438.C
439.E
440.A
525.EF
526.CE
527.BE
528.AD
613.AC
614.ABC
615.CE
616.AF
OBG-5.6.
Perinatal care of the neonate should include:
A) the removal of the vernix
B) intubation
C) oxygen administration
D) removal of the mucus from the mouth and pharynx of the
neonate .
E) all of the above
OBG-5.7.
The first step in the care of a patient with eclampsia is:
A) phlebotomy
B) termination of the pregnancy
C) the transfusion of blood
D) correction of the hemoconcentration (volume depletion)
E) the intravenous administration of diazepam
OBG-5.8.
Prior to the surgical extraction of the placenta:
A) any shock must be completely corrected
B) blood for any required transfusion should be made available
C) any performed blood transfusions must have been completed
before the extraction
D) all of the above
E) none of the above
OBG-5.9.
Currently, the most effective contraceptive method is the:
A) oral (hormonal) contraceptive
B) condom
C) cervical diaphragm
D) calendar rhythm method (periodic abstinence)
E) intrauterine device
OBG-5.10.
Which of the following results from the "Tests of Thyroid Function"
are elevated in a normal pregnancy?
A) the basal metabolic rate
B) the butanol-extractable iodine
C) the PBI (protein-bound iodine)
D) all of the above
E) none of the above
OBG-5.12.
In Rh-isoimmunization the most sensitive prognostic test is:
A) the previous history
B) fetal movements
C) maternal toxemia
D) the antibody titer
E) spectrophotometry of the amniotic fluid
OBG-5.13.
The correct gynecologic history should contain the following data:
A) menstrual history
B) previous deliveries
C) family history
D) previous diseases
E) all of the above
OBG-5.16.
Case Study:
A 39-year-old nulliparous woman presents with a one-week delay of
her last expected menstrual period. The patient has never taken any
contraceptives and was married 6 months ago. She has always had a
regular menstrual cycle. On examination, the cervix is soft and of a
bluish-purple color and the adnexal structures are not palpable. Which
of the following methods is suitable for the earliest possible recognition
of pregnancy?
A) -hCG radioimmunoassay
B) ultrasonography
C) a measurement of the basal body temperature
D) "palm leaf' arborization (ferning) of the cervical mucus
E) progesterone withdrawal
OBG-5.17.
Case Study:
A 19-year-old nulliparous woman in her 35th week of pregnancy
presents with nausea, blurred vision and a weight gain of 4.5 kg per
week. Her blood pressure is 160/110 mmHg. Which of the following
tests is the most suitable for the assessment of fetal status?
A) amniocentesis for the measurement of the lecithin/
sphingomyelin (L/S) ratio
B) amniocentesis for the measurement of the creatinine level of
the amnotic fluid
C) sonographic cephalometry
D) a non-stress test (NST)
E) an oxytocin challenge test (OCT)
OBG-5.18.
Case Study:
You are attending to a 36 year-old gravida in the 8 the week of gestation
(the patient had 6 pregnancies and 5 deliveries previously). The patient
is concerned about delivering a baby with congenital abnormalities. In
which week of the pregnancy should amniocentesis be performed?
A) immediately (in the 8th week)
B) in the 10th week
C) in the 12th week
D) in the 15th week
E) in the 24th week
OBG-5.19.
Case Study:
A 41-year-old multiparous (7 pregnancies ,7 deliveries) woman is undergoing
a vaginal hysterectomy and reconstructive surgery for
uterovaginal prolapse. She has been taking oral contraceptives for the
last 10 years. Which of the following potential complications is the
most likely associated with contraceptive use?
A) pneumonia
B) pulmonary embolism
C) retinal detachment
D) periorbital cellulitis
E) ileus
OBG-5.20.
Intrauterine exposure to which of the following substances is associated
with the development of clear cell vaginal carcinoma?
A) estrogen
B) testosterone
C) diethylstilbestrol
D) phenytoin
E) medroxyprogesterone
OBG-5.21.
Case Study:
A 29-year-old multiparous woman (4 pregnancies, 4 deliveries) undergoes
laparoscopic fulguration of the oviducts. Thirty-six hours after
the operation, the patient begins to complain about abdominal pain
and nausea. Her body temperature is 38.3 C and slight abdominal
distention is palpated. The most likely diagnosis is:
A) pelvic inflammation
B) hemorrhage from the uterine tube
C) thermal injury to the gut
D) a perforating injury to the gut resulting from a stab wound
E) tubal abortion
OBG-5.22.
Case Study:
You are attending to an 18-year-old unmarried girl admitted to the
intensive care unit with shaking chills, 39.4 C fever, 80/40 mmHg
blood pressure, moderate vaginal bleeding, abdominal tenderness and
a history of having lost her consciousness twice. The pelvic examination
denotes a slightly enlarged and softened uterus. Which of the
following procedures is not indicated?
A) a complete blood count
B) a blood culture and peripheral blood smear
C) a chest x-ray and plain abdominal x-ray in the standing position
D) dilation and curettage
E) laparoscopy
OBG-5.23.
Case Study:
In a 26-year-old pregnant woman, uterine growth stops abruptly in
the 4th month of gestation. The uterus begins to involute but 6 weeks
later a spontaneous abortion has still not occurred. Which of the following
parameters should be primarily monitored?
A) the hematocrit and hemoglobin levels
B) the fibrinogen level
C) the blood urea nitrogen (BUN) level
D) the serum creatinine level
E) the bilirubin level
OBG-5.24.
Which of the following conditions is characterized by the classic syndrome
of amenorrhea with or without abnormal vaginal bleeding,
pelvic-abdominal pain and an adnexal mass?
A) a tubo-ovarian abscess
B) intermenstrual pain (Mittelschmerz)
C) an ectopic pregnancy
OBG-5.37
Oocytes in the ovaries of a neonate are in the following developmental
stage:
A) in the prophase of the first meiotic division
B) at the appearance of oogonia (primordial germ cells)
C) in the stage of maturation
D) in the anaphase of the second meiotic division
E) none of the above
OBG-5.38.
The development of the primitive fetal circulation is assumed to be
complete by which of the following period?
A) 7 days after the maturation of the follicle
B) 10 days after the maturation of the follicle
C) 21 days after the maturation of the follicle
D) 60 days after the maturation of the follicle
E) 90 days after the maturation of the follicle
OBG-5.39.
Which of the following methods is appropriate for the detection of
pregnancy at the earliest time possible?
A) a pelvic examination
B) a progesterone level determination
C) the erythrocyte sedimentation rate
D) the erythrocyte agglutination-inhibition test
E) a measurement of the hCG -subunit serum levels
OBG-5.40.
Following exposure to excessive heat, the previously normal sperm
count will begin to reduce within:
A) a day
B) 7 days
C) 10 days
D) 75 days
E) 300 days
OBG-5.41
The average volume of menstrual blood loss is:
A) 5 to 10 ml
B) 10 to 15 ml
C) 25 to 50 ml
D) 150 to 200 ml
E) 250 to 300 ml
OBG-5.42.
Which of the following sequences specify the order of contraceptive
methods in decreasing efficacy?
A) oral contraceptives, diaphragm, intrauterine devices,
spermicidal agents, calendar rhythm method
B) intrauterine devices, oral contraceptives, diaphragm,
spermicidal agents, calendar rhythm method
C) calendar rhythm method, oral contraceptives, intrauterine devices,
diaphragm, spermicidal agents
D) oral contraceptives, intrauterine devices, spermicidal agents,
diaphragm, calendar rhythm method
E) oral contraceptives, intrauterine devices, diaphragm,
OBG-5.54.
All of the following procedures are valuable in the diagnosis of an
ectopic pregnancy, EXCEPT:
A) a pregnancy test
B) a diagnostic puncture of the Douglas' cul-de-sac (culdocentesis)
C) the erythrocyte sedimentation rate
D) ultrasonography
E) a pelvic (vaginal) examination
OBG-5.55.
Case Study:
An adnexal mass is detected by routine screening in a 40-year-old
female patient. Which of the following methods is the least helpful
for the assessment of the lesion?
A) pelvic ultrasonography
B) measurement of the serum bilirubin levels
C) pelvic CT-scan
D) laparoscopy
E) MRI
OBG-5.56.
In females sensitized to Rh antigens, amniocentesis is performed in
orderto:
A) measure antibody titers
B) determine the lecithin / sphingomyelin (L/S) ratio
C) perform the Kleihauer-Betke test
D) perform spectrophotometry
E) obtain a Gram stain
OBG-5.57.
According to the experience of Masters and Johnson as well as other
sexual-therapists, the success-rate of therapy is the lowest in:
A) premature ejaculation
B) vaginismus
C) primary impotence
D) secondary impotence
E) inhibited orgasm
OBG-5.58.
The most important risk factor of developing breast cancer is:
A) the presence of sclerosing adenosis
B) nulliparity
C) atypical lobular hyperplasia
D) the use of intrauterine devices
E) menarche occurring before the age of twelve
OBG-5.59.
The most prevalent cause of precocious puberty in girls is:
A) idiopathic causes
B) gonadal neoplasms
C) Albright's syndrome
D) hypothyroidism
OBG-5.60
Case Study:
OBG-5.71.
Which of the following statements is true regarding neural tube defects?
A) in Hungary, the overall incidence of these defects is 15-20%
B) maternal serum a-fetoprotein levels are invariable during pregnancy
C) a-fetoprotein cannot be detected in the amniotic fluid
D) 95-99% of all neural tube defects can be detected by
amniocentesis and meticulous ultrasonography
E) none of the above
OBG-5.73.
The pH value of amniotic fluid is in the range of:
A) 2.5-3.0
B) 3.0-3.5
C) 4.5-5.5
D) 5.5-6.0
E) 7.0-7.5
OBG-5.74.
Which of the following statements regarding suppurative mastitis is valid?
A) the symptoms usually present in the 10th postpartum week
B) herpesvirus is the most common causitive pathogen
C) the most common cause of masititis is poor personal hygiene
of the mother
D) the pathogen can never be cultured from breast milk
E) the source of infection is almost invariably the nose and throat
of the nursing infant
OBG-5.75.
The anteroposterior diameter of the pelvic rim is the shortest along the:
A) interspinous diameter
B) anatomical conjugate
C) diagonal conjugate
D) obstetric conjugate
E) none of the above
OBG-5.79.
Case Study:
A 19-year-old woman is referred to the emergency room for a sudden
loss of consciousness at her job. The examination reveals slight vaginal
bleeding; the abdomen is distended and diffusely tender. The patient
complains of shoulder- and abdominal pain. Body temperature: 36.4
C; heart-rate: 120/min; blood-pressure: 96/50 mmHg. Which of the
following diagnostic procedures should be performed to verify the tentative
diagnosis established by evaluating the available clinical data?
A) a pregnancy test
B) posterior colpotomy
C) dilation and curettage
D) diagnostic puncture of the cul-de-sac
E) hysteroscopy
OBG-5.80.
Case Study:
A 24-year-old pregnant woman is in the 8th week of gestation. Her
medical history includes a pulmonary embolism that occurred 7 years
ago during her previous pregnancy. She was given intravenous heparin
at that time followed by oral warfarin (coumarin) therapy for several
months. The patient has not experienced any signs of thromboembolism
for the last 6 years. Which of the following statements is correct regarding
the current condition of the patient?
A) considering the 5-year-long disease-free period, the risk of a recurrent
thromboembolism is not higher than in normal cases
B) in pregnancy, impedance plethysmography is unsuitable for
the evaluation of deep-vein thrombosis
C) in pregnancy, Doppler -ultrasonography is unsuitable for the
evaluation of deep-vein thrombosis
D) low-dose heparin therapy should be started and continued
throughout the pregnancy and puerperium
E) the risk of a recurrent thromboembolism is the highest in the
second trimester of pregnancy
OBG-5.81.
All of the following statements are valid regarding appendicitis developing
during pregnancy, EXCEPT:
A) this condition is difficult to diagnose
B) the maternal mortality rate increases with the progression of the
pregnancy
C) surgery should be postponed until the establishment of a conclusive
diagnosis
OBG-5.119.
Which of the following tests is unnecessary during the first trimester
of pregnancy?
A) a urinalysis
B) blood pressure measurements
C) measurements of the body weight
D) measurements of the abdominal circumference
E) vaginal examinations
OBG-5.120.
Which of the following is not a routine test at follow-up visits during
pregnancy?
A) serologic tests for syphilis (STS)
B) hematocrit measurements
C) measurements of the hemoglobin level
D) urinalysis
E) liver function tests
OBG-5.121
Which of the following urinary parameters is/are mandatory when
being tested at follow-up visits during pregnancy?
A) the presence of any pus
B) the glucose level
C) the concentration of protein
D). all of the above
E) only answers (A) and (C) are true
0BG-5.122
The optimal monthly gain of body weight during pregnancy is:
A) 0.5-0.6 kg
B) 1.0-1.5 kg
C) 1.5-2.0 kg
D) 2.0-2.5 kg
E) 2.5-3.0 kg
OBG-5.123.
The daily protein requirement of pregnant women is as high as:
A) 60-180 g/day
B) 100-150 g/day
C) 150-200 g/day
D) 200-300 g/day
E) 300-350 g/day
OBG-5.124.
The daily carbohydrate requirement of pregnant women is as
high as:
A) 60-80 g/day
B) 100-150 g/day
C) 150-200 g/day
D) 200-300 g/day
E) 300-350 g/day
OBG-5.125.
The daily fat requirement of pregnant woman is as high as:
A) 60-80 g/day
B) 100-150 g/day
C) 150-200 g/day
D) 200-300 g/day
E) 300-350 g/day
OBG-5.126.
The proper method for preparing the nipples for breastfeeding is:
A) washing the nipples with soap every morning and evening
B) massage of the nipple and the areola
C) only answers (A) and (B) are true
D) no preparation is necessary
OBG-5.127.
Administered in high doses, which of the following drugs does not
cause fetal damage?
A) barbiturates
B) ganglionic blockers
C) vitamin K
D) morphine and its derivatives
E penicillins
OBG-5.128.
Which of the following drugs is contraindicated during pregnancy?
A) coumarins
B) oral antidiabetic agents
C) actinomycin D
D) cytotoxic agents
E) all of the above
OBG-5.129
Which of the following drugs is contraindicated during pregnancy?
A) thalidomide
B) methimazole
C) vitamin K in high doses
D) all of the above
E) only answers (A) and (B) are true
OBG-130.
Which of the following drugs is contraindicated during pregnancy?
A) quinine
B) cytotoxic agents
C) streptomycin (permanent therapy)
D) all of the above
E) only answers (A) and (B) are true
OBG-5.131.
Which of the following drugs should not be administered during
pregnancy?
A) streptomycin
B) sulfonamides
C) carbutamide
D) all of the above
E) only answers (A) and (C) are true
OBG-5.132.
In which weeks of pregnancy is ultrasonography recommended for
OBG-5.142.
In patients with group III heart disease, (based on the former practice
of functional staging), how should labor be managed:
A) by cesarean section with sterilization in all cases
B) heart disease is only an additional indication for cesarean
section
C) cesarean section is performed only on obstetrical indications
D) the 2nd stage of labor should be shortened by performing
vacuum-extraction
E) the duration of labor should be-reduced by administering an
infusion of oxytocin
OBG-5.143.
In patients with group IV heart disease, (based on the former practice
of functional staging), how should labor be managed:
A) by cesarean section with sterilization in all cases
B) heart disease is only an additional indication for cesarean
section
C) cesarean section is performed only on obstetrical indication
D) the 2nd stage of labor should be shortened by performing
vacuum-extraction
E) 90-100%
OBG-5.177.
What is the likelihood of delivering a baby with congenital malformations
after a rubella infection occurring in the first 8-12 weeks of pregnancy?
A) 5-10%
B) 40-50%
C) 60-70%
D) 80-90%
E) 90-100%
OBG-5.178.
Which of the following titers of hemagglutinating antibodies suggests
an acute rubella infection?
A) > 1:32
B) 1:16+
C) 1:8+
D) an antibody titer of at least two grades higher than the initial low
titer
E) the decrease of high antibody titers is followed by an increase
of these titers
OBG-5.179.
How does pregnancy influence maternal hepatitis?
A) pregnancy aggravates maternal hepatitis
B) pregnancy alleviates maternal hepatitis
C) pregnancy has no effect on maternal hepatitis
OBG-5.180.
The unequivocal diagnosis of toxoplasmosis can be established by the:
A) complement fixation reaction
B) Sabin-Feldman dye test
C) intracutaneous testing with toxoplasma antigen
D) all of the above
OBG-5.181.
The complications of toxoplasmosis developing during pregnancy include:
A) abortion
B) premature delivery
C) intrauterine fetal death
D) all of the above
E) none of the above
OBG-5.182.
Which of the following conditions suggests congenital toxoplasmosis
of the neonate?
A) hydrocephalus with focal cerebral calcification
B) retinitis, uveitis and pigment deposits on the ocular fundus
C) hepatosplenomegaly, protracted jaundice
D) all of the above
E) only answers (A) and (B) are true
OBG-5.183.
In listeriosis, the pathogen can be cultured from the:
A) blood
B) cerebrospinal fluid
C) feces
D) urine
E) all of the above
OBG-5.184.
Suspected neonatal listeriosis is best verified by culturing a specimen of
A) vernix
B) blood
C) meconium
D) amniotic fluid
E) all of the above
OBG-5.185.
What is a primary or primordial follicle?
A) an immature follicle surviving into the postmenopausal period
B) a dormant follicle devoid of maturation changes
C) a mature follicle developed under the effect of gonadotropic hormone
D) the first mature follicle in puberty
E) a follicle undergoing degeneration in the child-bearing age
OBG-5.186.
Which of the following agglutinating antibody titers suggests
listeriosis requiring treatment?
A) 1:8
B) 1:16
C) 1:32
D) 1:128
E) 1:526
OBG-5.187.
Which of the following drugs is appropriate for the treatment of
listeriosis?
A) penicillin and sulfonamides
B) tetracycline
C) quinacrine (Daraprim) and sulfonamides
D) chloramphenicol
OBG-5.188.
Fetal affects of syphilis include:
A) intrauterine fetal death
B) abortion
C) premature birth
D) all of the above
E) none of the above
OBG-5.189.
In pregnancy, Treponema pallidum can penetrate the placenta in week:
A) 6
B) 12
C) 20
D) 28
E) 36
OBG-5.190.
In which of the following cases is the performance of serologic tests
for syphilis justified?
OBG-5.196.
Characteristic features of latent (gestational) diabetes include?
A) the presence of symptoms; high blood-glucose levels
B) the absence of clinical symptoms; normal blood-glucose levels,
impaired glucose tolerance
C) the absence of clinical symptoms; normal blood-glucose levels and
glucose tolerance, however, the enhanced glucose tolerance test yields
abnormal results
D) clinical symptoms are absent; blood-glucose levels and the results
of both the glucose tolerance test and .the enhanced glucose
tolerance tests are normal
OBG-5.197.
Which of the following may suggest potential diabetes?
A) the delivery of a neonate of over 4,000 g body weight
B) either parent or both of them are diabetics
C) obesity, sudden weight-gain
D) all of the above
E) only answers (A) and (B) are true
OBG-5.198
Which of the following jeopardize women with gestational diabetes?
A) the derangement of carbohydrate metabolism
B) the derangement of water- and electrolyte balance
C) toxemia, urinary tract infection and vaginitis develop frequently
B) jaundice
C) polyneuritis, retinal hemorrhages
D) all of the above
E) only answers (A) and (B) are true
OBG-5.219.
Which of the following laboratory tests should be performed in
hyperemesis of pregnancy?
A) urine volume; specific gravity; protein, acetone and
urobilinogen content
B) urinary sediment examination
C) measurement of the hematocrit and hemoglobin levels
D) measurement of the serum bilirubin level
E) all of the above
OBG-5.220.
In hyperemesis gravidarum, hematocrit and hemoglobin values are:
A) elevated
B) reduced
C) unchanged
OBG-5.221.
The therapy of hyperemesis gravidarum includes:
A) bed rest
B) parenteral fluid therapy, and nutrition
C) administration of antiemetics
D) administration of sedatives
E) all of the above
OBG-5.222.
In Hungary. the incidence of toxemia developing late in pregnancy is:
A) 1-2%
B) 5-10%
C) 25-40%
D) 40-50%
E) 50-60%
OBG-5.223.
What is the ranking of toxemia of pregnancy among the causes of
maternal mortality?
A) first
B) second
C) third
D) fourth
E) fifth
OBG-5.225.
The cause of generalized vasoconstriction developing in late occurring
toxemia of pregnancy is:
A) vasopressor substances produced in the placenta
B) increased sensitivity of small arterioles to pressor agents
C) only answers (A) and (B) are true
D) adrenal hyperfunction
E) altered sensitivity of the blood-pressure regulating centre
OBG-5.226.
A) tonic-clonic seizures
B) prodromal stage, tonic-clonic seizures, coma
C) tonic-clonic seizures, coma
D) clonic seizure, coma
E) prodromal stage, clonic seizure, coma
OBG-5.241
Eclamptic seizures may develop:
A) in pregnancy
B) at delivery
C) during the puerperium
D) all of the above
E) during pregnancy and at birth only
OBG-5.242
The term "primary (genuine) toxemia of pregnancy" means:
A) condition with cumulative occurrence within the family
B) that no organic disease can be detected
C) toxemic symptoms associated with hypertension as well as renal
and vascular disease
D) symptoms developing in the first half of pregnancy
E) symptoms associated with.multiple pregnancy
OBG-5.243.
" The term "superimposed toxemia"means:
A) condition with cumulative occurrence within the family
B) that no organic disease can be detected
C) toxemic symptoms associated with hypertension as well as renal
and vascular disease
D) symptoms precipitated by improper diet or life-style
E) symptoms associated with multiple pregnancy
OBG-5.245.
Which of the following methods is appropriate for evaluating the severity
of late occurring toxemia of pregnancy?
A) the measurement of blood pressure
B) the measurement of urinary protein concentration
C) assessing the severity of edema as well as the patient's subjective
symptoms
D) all of the above
E) only answers (B) and (C) are true
OBG-5.247.
In which of the following cases should polysymptomatic toxemia be
considered severe?
A) if the blood pressure is higher than 180/130 mmHg and
retinopathy is present
B) if the grade of proteinuria exceeds 5 0/000
C) if gerenalized edema is present
D) in all of the above cases
E) only answers (A) and (B) are true
OBG-5.248
Which of the following methods is appropriate for the diagnosis of
late occurring toxemia of pregnancy?
A) the measurement of blood pressure
B) urinalysis
C) body weight monitoring
D) all of the above
E) only answers (A) and (B) are true
OBG-5.249
Late consequences of eclamptic seizures include:
A) neurovegetative disturbances, psychosis
B) epilepsy and memory disturbances
C) permanent renal and vascular damage
D) all of the above
E) only answers (B) and (C) are true
OBG-5.250.
Which of the following indicates the severity and prognosis of
eclampsia correctly?
A) the time of the onset of toxemia
B) the number and frequency of seizure-attacks as well as the
depth of ensuing coma
C) the rate of diuresis
D) all of the above
E) only answers (B) and (C) are true
OBG-5.251.
The maternal risks of late occurring toxemia of pregnancy include:
A) death
B) afibrinogenia, premature separation of the placenta
C) permanent renal and vascular damage
D) all of the above
E) only answers (B) and (C) are true
OBG-5.252.
Fetal risks of late occurring toxemia of pregnancy include:
A) premature birth
B) dysmaturity
C) intrauterine fetal death
D) only answers (A) and (B) are true
E) all of the above
OBG-5.253.
Which of the following determines the severity of fetal damage due to
toxemia of pregnancy?
A) the severity of toxemia
B) the duration of toxemia
C) the character of toxemia, i.e. whether it is primary or superimposed
D) all of the above
E) only answers (A) and (B) are true
OBG-5.255.
Essential principles of therapy of late occurring toxemia of pregnancy
include:
A) the provision of appropriate rest
B) the prescription of a protein-rich diet and abstinence from
spicy food
C) the alleviation of edema
D) the administrationof antihypertensives and sedatives
C) complete abortion
D) incipient abortion
OBG-5.269.
Which type of abortion is characterized by cramping lower abdominal
pain, vaginal bleeding and a closed cervix?
A) incipient abortion
B) imminent abortion
C) incomplete abortion
D) missed abortion
E) post-abortion residue
OBG-5.270.
Which type of abortion is characterized by cramping lower abdominal
pain, vaginal bleeding, an open cervix but no passage of the
products of conception?
A) incipient abortion
B) imminent abortion
C) incomplete abortion
D) missed abortion
E) post-abortion residue
OBG-5.271.
Which type of abortion is characterized by cramping lower abdominal
pain, vaginal bleeding, an open cervix and the passage of the
products of conception?
A) incipient abortion
B) imminent abortion
C) incomplete abortion
D) missed abortion
E) habitual abortion
OBG-5.272.
Which of the following is the most important feature for distinguishing
between imminent and incipient abortion?
A) the volume of blood loss
B) cramps
C) the bore of the dilated cervix
D) the results of the biological pregnancy test
E) serum progesterone level
OBG-5.273.
Which of the following is the most important feature for distinguishing
between incipient and incomplete abortion?
A) the volume of blood loss
B) the bore of the dilated cervix
C) the passage of the products of conception
D) the results of the biological pregnancy test
E) serum progesterone level
OBG-5.274.
In which of the following conditions can the administration of
progestogenic
agents be considered reasonable for the therapy of imminent abortion?
A) if the history contains spontaneous abortion
B) if lower abdominal cramps are present
C) if bleeding is present
D) if the serum progesterone level is low
E) in all patients with lower abdominal pain
OBG-5.275.
The risks of terminating spontaneous abortions by curettage include:
A) infection
B) bleeding resulting from intrauterine residue
C) uterine perforation and surgical injury
D) all of the above
E) only answers (A) and (B) are true
OBG-5.276.
Which of the following is the time-limit for terminating the pregnancy
of women under 18 on non-medical indication?
A) week 12 of gestation
B) week 14 of gestation
C) week 16 of gestation
D) week 18 of gestation
E) week 20 of gestation
OBG-5.277.
Which of the following is the time-limit for terminating the pregnancy
on medical indication?
A) week 12 of gestation
B) week 16 of gestation
C) week 20 of gestation
D) week 24 of gestation
E) there is no upper limit
OBG-5.278.
Which is the maternal age that justifies the termination of pregnancy
on non-medical indication?
A) over 30 years
B) over 35 years
C) over 40 years
D) over 45 years
E) maternal age should not be considered as an indication for
pregnancy termination
OBG-5.279.
Medical indications for pregnancy termination include:
A) cases where continuation of the pregnancy would interfere
with the therapy of the underlying disease
B) cases where pregnancy aggravates the underlying disease
C) cases where the maternal disease jeopardizes the well-being of
the fetus
D) all of the above
E) only answers (B) and (C) are true
OBG-5.280.
What is the time limit for terminating the pregnancy on social
indication?
A) week 8 of gestation
B) week 12 of gestation
C) week 16 of gestation
D) week 20 of gestation
E) week 24 of gestation
OBG-5.281.
In obstetrical terms, premature delivery means the termination of
pregnancy:
A) between weeks 12-16 of gestation
B) between weeks 16-28 of gestation
C) between weeks 28-37 of gestation
D) between weeks 38-40 of gestation
E) when the weight of the fetus is 2499 grams or less
OBG-5.282.
Which of the following factors maintain the integrity of pregnancy?
A) progesterone and oxytokinase
B) -receptor stimulation
C) anatomical and functional integrity of the cervical sphincter
and connective tissue fibers
D) all of the above
E) only answers (A) and (B) are true
OBG-5.283.
Is active immunization against mumps and varicella permitted during
pregnancy?
A) yes
B) no
C) it is permitted under certain conditions
OBG-5.284.
Is passive immunization against mumps and varicella permitted
during pregnancy?
A) yes
B) no
C) it is permitted under certain conditions
OBG-5.285.
Is passive immunization against rubella permitted during pregnancy?
A) yes
B) no
C) it is permitted under certain conditions
OBG-5.286.
When does labour start?
A) at the time of full dilation and effacement of the cervix
B) at the time when the maximum circumference of the fetal head
has descended below the pelvic rim
C) at the time when rhythmic, expulsive uterine contractions resulting
in the dilation of the cervix begin
D) at the time of complete cervical dilation
when the patient begins to feel the urge to bear down
OBG-5.287.
When does the 1st stage of labor start and end?
A) from the time of full cervical effacement to the delivery of the
fetus
B) from the delivery of the fetus to the expulsion of the placenta
C) from the start of uterine contractions to the effacement of the
cervix
D) this period corresponds to the first 2 hours following the delivery
of the placenta
E) from the start of uterine contractions to the delivery of the fetus
OBG-5.288.
When does the 2nd stage of labor start and end?
A) from the time of full cervical effacement to the delivery of the
fetus
B) from the delivery of the fetus to the expulsion of the placenta
C) from the start of uterine contractions to the effacement of the
cervix
D) this period corresponds to the first 2 hours following the delivery
of the placenta
E) from the start of uterine contractions to the delivery of the fetus
OBG-5.289.
When does the 3rd (placental) stage of labor start and end?
A) from the time of full cervical effacement to the delivery of the
fetus
B) from the delivery of the fetus to the expulsion of the placenta
C) from the delivery of the fetus to the end of a 2-hour period following
the expulsion of the placenta
D) this period corresponds to the first 2 hours following the delivery
of the placenta
E) from the start of uterine contractions to the delivery of the fetus
OBG-5.290.
When does the postplacental stage of labor start and end?
A) from the time of full cervical effacement to the delivery of the
fetus
B) from the delivery of the fetus to the expulsion of the placenta
C) from the delivery of the fetus to the end of a 2-hour period following
the expulsion of the placenta
D) this period corresponds to the first 2 hours following the delivery
of the placenta
E) from the start of uterine contractions to the delivery of the fetus
OBG-5.291.
"Predictory contractions":
A) propel the fetus along the osseous and soft tissue passage after
the complete effacement of the cervix
B) are uterine contractions resulting in the effacement of the cervix
C) induce the separation and delivery of the placenta
D) are contractions occurring during the first days of the puerperium
E) brief uterine contractions occurring at irregular intervals during
the last weeks of pregnancy
OBG-5.292.
Which of the following factors are involved in the induction of labor?
A) the reduction of the effects of hormones produced by the corpus
luteum
B) labor-stimulating hormones
C) neural changes
D) the hyperextension of uterine musculature and the pressure
exerted by the presenting part on cervical ganglia
labor is:
A) 1-2 mmHg
B) 5-10 mmHg
C) 55-100 mmHg
D) 200-500 mmHg
OBG-5.313.
The rise of intrauterine pressure generated by bearing down during
the 2nd stage of labor is as high as:
A) 1-2 mmHg
B) 3-5 mmHg
C) 10 mmHg
D) 50 mmHg
E) 100 mmHg
OBG-5.314.
The average intensity of uterine activity during the 2nd stage of
labor is:
A) 1-2 M.U.
B) 5-10 M.U.
C) 50-100 M.U.
D) 280-300 M.U.
E) 400-500 M.U.
OBG-5.315.
The average intensity of uterine contractions during the 3rd (placental)
stage of labor is:
A) 1-2 mmHg
B) 3-5 mmHg
C) 6-10 mmHg
D) 30-40 mmHg
E) 70-80 mmHg
OBG-5.316.
Factors contributing to the development of caput succedaneum include:
A) the effect of negative pressure exerted by the cervix on the fetal
head
B) the strangulation caused by the contact ring
C) fetal hypoxia
D) all of the above
E) only answers (A) and (B) are true
OBG-5.317.
Caput succedaneum may develop in:
A) a live fetus
B) a dead fetus only
C) both in the live and dead fetuses
D) in premature neonates only
OBG-5.318.
Preparatory contractions:
A) propel the fetus along the osseous and soft tissue passage after
the complete effacement of the cervix
B) are uterine contractions resulting in the effacement of the cervix
C) induce the separation and delivery of the placenta
D) are contractions occurring during the first days; of the puerperium
OBG-5.331.
In the case of head presentation and cephalic position delivery,
which of the following describes the rotations of the fetal head correctly?
A) rotation, deflexion, flexion, external rotation
B) flexion, rotation, deflexion, external rotation
C) deflexion, rotation, flexion, external rotation
D) rotation, deflexion, flexion, external rotation
E) flexion, deflexion, rotation, external rotation
OBG-5.332.
In which section of the birth canal does the fetal skull perform its
second rotation during cephalic position delivery?
A) at the pelvic brim
B) in the cavity of the pelvis
C) at the pelvic outlet
D) outside the vulva
OBG-5.333.
In which section of the birth canal does the fetal skull perform its
third rotation during cephalic position delivery?
A) at the pelvic brim
B) in the cavity of the pelvis
C) at the pelvic outlet
D) outside the vulva
OBG-5.334.
In which section of the birth canal does the fetal skull perform its
fourth rotation during cephalic position delivery?
A) at the pelvic brim
B) in the cavity of the pelvis
C) at the pelvic outlet
D) outside the vulva
OBG-5.335.
Which part of the fetal skull leans against the nether region of the
symphysis?
A) the margin of the scalp
B) the occiput
C) the maxilla
D) the submental region
E) the glabella
OBG-5.336.
The signs of complete placental separation include:
A) ridging of the uterus
B) the umiblical cord is not retracted by pressure applied to the
lower abdomen above the symphysis
C) the umbilical cord is not retracted after bearing down
D) all of the above suggest separation of the placenta
E) only answers (A) and (B) are true
OBG-5.337.
The Tsukhaloff-Kiistner's sign
A) is elicited by pressing the lower abdomen while observing the
retraction of the umbilical cord
B) means that the uterus loses its globoid shape and becomes
flattened and flaccid
C) means that the umbilical cord is not retracted after bearing
down
D) means that the separated placenta is expressed from the
uterine cavity like a seed of a plum by applying pressure to the
uterine fundus
E) means rubbing the fundus in order to elicit uterine contraction
OBG-5.338.
Klein's sign
A) means that the umbilical cord is not retracted when pressure
is applied to the lower abdomen above the symphysis
B) means that the uterus loses its globoid shape and becomes
flattened and flaccid
C) means that the umbilical cord is not retracted after bearing
down if the separation of the placenta is complete
D) means that the separated placenta is expressed from the
uterine cavity like a seed of a plum by applying pressure to the
uterine fundus
OBG-5.339.
Where can the upper pole of the uterine fundus be found after delivery
of the placenta?
A) at the umbilical level
B) about 3 centimetres above the symphysis
C) about 6 centimetres above the symphysis
D) at the level of the symphysis
E) in the pelvic cavity
OBG-5.340.
Where can the upper pole of the uterine fundus be found on the first
day of the puerpuerium?
A) about 3 centimetres above the umbilicus
B) at the umbilical level
C) about 6 centimetres above the symphysis
D) at the level of the symphysis
E) in the pelvic cavity
OBG-5.341.
Which of the following should be determined on admission to the
delivery room?
A) the presenting part should be identified and its relative location
to the pelvic brim should be determined
B) the integrity of the fetal membranes and the color of the amniotic
fluid
C) fetal cardiac function and the dilation of the cervix should be
assessed
D) uterine contractions should be evaluated
E) all of the above
OBG-5.342.
Which of the following features of expulsive contractions can be assessed
by palpation?
A) frequency
B) duration
C) intensity
D) basal tone
E) all of the above
OBG-5.343..
Which of the following cannot be determined by vaginal examination
performed during labor?
A) the degree of dilation and effacement of the cervix
B) the integrity of fetal membranes
C) neither the presenting part nor its position in the birth canal
can be determined
D) the risk of fetal hypoxia
E) the location of the governing point and path
OBG-5.344.
In which of the following cases is vaginal examination indicated during
labor?
A) if the progress of the presenting part is inadequate despite
normal uterine activity
B) it is mandatory before obstetrical surgery
C) if abnormal engagement, presentation or position is suggested
by the findings of rectal digital examination
D) all of the above
OBG-5.345.
The essentials of active management of the 3rd stage of labor include:
A) after the delivery of the fetus, the uterine fundus is rubbed in
order to aid in the firm contraction of the uterus
B) after the delivery of the fetus, the placenta is removed by
Crede's maneuver
C) an oxytocic drug is given immediately after the delivery of the
fetus
D) after the delivery of the fetus, the separation and expulsion of
the placenta is aided by exerting traction on the umibilical
cord
E) the separation of the placenta should be patiently waited for,
without rubbing or massaging the uterus
OBG-5.346.
The essentials of conservative management of the 3rd stage of labor
include:
A) after the delivery of the fetus, the uterine fundus is rubbed to
aid the firm contraction of the uterus
B) after the delivery of the fetus, the placenta is removed by
Cred's maneuver
C) an oxytocic drug is given immediately after the delivery of the
fetus
D) after the delivery of the fetus, the separation and expulsion of
the placenta is aided by exerting traction on the umibilical
cord
E) the separation of the placenta should be patiently waited for,
without rubbing or massaging the uterus
OBG-5.347.
In which of the following cases should the delivered placenta be examined?
A) if the separation of the placenta was difficult
B) 9-11 centimeters
C) 7-9 centimeters
D) less than 7 centimeters
OBG-5.367.
The consequences of prolonged labor include:
A) ascending uterine infection
B) intrauterine asphyxia
C) bleeding resulting from uterine atony
D) all of the above
E) only answers (A) and (B) are true
OBG-5.368.
The prevalence of breech presentation in premature labor is:
A) 1-2%
B) 3-4%
C) 10-12%
D) 30-40%
OBG-5.369.
The prevalence of breech presentation in all deliveries is:
A) 1-2%
B) 4-5%
C) 15-20%
D) 30-40%
OBG-5.370.
The prevalence of breech presentation in multiple pregnancies is:
A) 1-2%
B) 3-5%
C) 6-10%
D) 20-25%
OBG-5.371.
The prevalence of breech presentation before week 28 of gestation is:
A) 1-2%
B) 3-5%
C) 30-40%
D) 80-90%
OBG-5.372.
The prevalence of breech presentation before week 32 of gestation is:
A) 10%
B) 30-40%
C) 50-60%
D) 70-80%
0BG-5.373.
Which of the following is the presenting part in single feet presentation?
A) the buttocks and one of the feet
B) both knees
C) one of the knees
D) one of the legs
E) both legs
OBG-5.374.
OBG-5.381.
Compared to cephalic presentation delivery, which of the following
represent an increased disadvantage during breech delivery?
A) the fetal head compresses the umbbilical cord
B) the fetal head has no chance to mold to fit pelvic size
C) upward displacement of the fetals arms may cause fracture
D) all of the above
E) breech presentation carries no additional disadvantage over
cephalic presentation delivery
OBG-5.382.
Where does venous and arterious blood mix in the fetal circulation?
A) the umbilical vein supplies the liver and coalesces to form the
branches of the hepatic vein then joins the inferior vena cava
B) considered an extension of the umbilical vein the ductus
venosus of Arandi joins the inferior vena cava
C) both the inferior and the superior vena cava empty into the
right atrium and their blood is mixed there
D) the ductus arteriosus (Botallo's duct), a branch of the pulmonary
artery, empties int6 the aorta
OBG-5.383.
By which postnatal week is the closure of the foramen ovale complete?
A) week 1-2
B) week 2-3
C) week 4-8
D) week 16-20
E) week 20-24
OBG-5.384.
How many days does the postnatal obliteration of the ductus venosus
take?
A) it is obliterated immediately after birth, during the first breath
B) 1-2 days
C) 2-3 days
D) 5-10 days
E) 20-30 days
OBG-5.385.
What is the cause of the increased heat loss off neonates and their
susceptibility to hypothermia?
A) the ratio of body surface area to body mass is significantly
higher in neonates than in adults
B) the subcutaneous fat layer is relatively thin
C) the activity of the thermoregulation centre is unstable
D) all of the above have a role in the development of hypothermia
E) only answers (A) and (B) are true
OBG-5.386.
What is the percentage of fetal urine in the volume of amniotic
fluid?
A) 1-2%
B) 2-4%
C) 20-40%
D) 60-70%
OBG-5.387.
What is the percentage of loss from birth weight in neonates?
A) 1-2%
B) 2-3%
C) 5-10%
D) 15-18%
E) 18-20%
OBG-5.388.
Which of the following characterizes neonatal thyroid function?
A) euthyrodism
B) hypothyroidism
C) hyperthyroidism
OBG-5.389.
What is the prevalence of congenital malformations detectable in
neonatal age?
A) 0.1%
B) 0.5%
C) 1.0%
D) 3.0%
E) 10.0%
OBG-5.390.
The term "genopathy" means:
A) fetal damage sustained between week 13 of gestation and the
time of birth
B) fetal damage susteined between weeks 2 and 13 of gestation
C) fetal damage sustained between the time of conception and
day 14 of gestation
D) damage to the ovum before fertilization resulting in the development
of various congenital malformations
E) fetal disease resulting from chromosomal or genetic abnormality
OBG-5.391.
The term "gametopathy" means:
A) fetal damage sustained between week 13 of gestation and the
time of birth
B) fetal damage susteined between weeks.2 and 13 of gestation
C) fetal damage sustained between the time of conception and
day 14 of gestation
D) damage to the ovum before fertilization resulting in the development
of various congenital malformations
E) fetal disease resulting from chromosomal or genetic abnormality
OBG-5.392.
The term "blastopathy" means:
A) fetal damage sustained between week 13 of gestation and the
time of birth
B) fetal damage susteined between weeks 2 and 13 of gestation
C) fetal damage sustained between the time of conception and
day 14 of gestation
D) damage to the ovum before fertilization resulting in the development
of various congenital malformations
E) fetal disease resulting from chromosomal or genetic abnormality
OBG-5.393.
The term "embryopathy" means:
A) fetal damage sustained between week 13 of gestation and the
time of birth
B) fetal damage susteined between weeks 2 and 13 of gestation
C) fetal damage sustained between the time of conception and
day 14 of gestation
D) damage to the ovum before fertilization resulting in the development
of various congenital malformations
OBG-5.394.
The term "fetopathy" means:
A) fetal damage sustained between week 13 of gestation and the
time of birth
B) fetal damage susteined between weeks 2 and 13 of gestation
C) fetal damage sustained between the time of conception and
day 14 of gestation
D) damage to the ovum before fertilization resulting in the development
of various congenital malformations
OBG-5.395.
In occult spina bifida:
A) defective closure of the vertebral column can be detected by
palpation or radiography only
B) the contents of the vertebral canal protrude as a cystic tumor
C) the protruding sac is covered by the meninges and contains
cerebrospinal fluid only
D) the protruding sac is covered by the meninges and contains
both a portion of the spinal cord and cerebrospinal fluid
OBG-5.396.
In complete spina bifida (rachischisis):
A) defective closure of the vertebral column can be detected by
palpation or radiography only
B) the contents of the vertebral canal protrude as a cystic tumor
C) the protruding sac is covered by the meninges and contains
both a portion of the spinal cord and cerebrospinal fluid
OBG-5.397.
In meningocele:
A) defective closure of the vertebral column can be detected by
radiography only
B) the contents of the vertebral canal protrude as a cystic tumor
C) the protruding sac is covered by the meninges and contains
both a portion of the spinal cord and cerebrospinal fluid
OBG-5.398.
In myelomeningocele:
A) defective closure of the vertebral column can be detected by
radiography only
B) the contents of the vertebral canal protrude as a cystic tumor
C) the protruding sac is covered by the meninges and contains
both a portion of the spinal cord and cerebrospinal fluid
OBG-5.399.
Which of the following test results suggest the presence of neural
tube defects?
A) high -fetoprotein level
B) ultrasonography
C) macrophages detected in the amniotic fluid
D) all of the above
E) only answers (A) and (B) are true
OBG-5.400.
What is the risk of the recurrence of the congenital malformations of
the central nervous system?
A) 1:1
B) 1:2-10
C) 1:20
D) 1:30-60
E) 1:200
OBG-5.401.
What is the risk of the recurrence of the congenital malformations of
the musculoskeletal system?
A) 1:5
B) 1:10-20
C) 1:50
D) 1:100
E) 1:200
OBG-5.402.
What is the risk of the recurrence of the congenital malformations of
the cardiovascular system?
A) 1:1
B) 1:5
C) 1:50
D) 1:200
E) 1:500
OBG-5.403.
What is the risk of the recurrence of the congenital malformations of
the cardiovascular system?
A) 1:1
B) 1:5
C) 1:50
D) 1:200
E) 1:500
OBG-5.404.
What is the risk of the recurrence of the congenital malformations of
the gastrointestinal system?
A) 1:10
B) 1:20
C) 1:50
D) 1:100
E) 1:200
OBG-5.405.
Which of the following conditions should be considered if meconium
ileus develops?
A) duodenal atresia
B) intestinal atresia
C) cystic fibrosis
D) phenylketonuria
E) biliary atresia
OBG-5.406.
Congenital dysplasia of the hip is more prevalent in:
A) boys
B) girls
C) there is no gender-specific difference
OBG-5.407.
The chromosomal abnormality characteristic of Down's syndrome
includes:
A) trisomy G21
B) D/G translocation
C) G/G translocation
D) all of the above
E) only answers (A) and (B) are true
OBG-5.408.
The chromosomal abnormality characteristic of Patau's. syndrome
includes:
A) trisomy G21
B) trisomy D
C) D/G translocation
D) G/G translocation
E) 45,X0 caryotype
OBG-5.409.
What is the prevalence of congenital malformations after rubella infections
occurring in the first trimester of pregnancy?
A) 1%
B) 5%
C) 15-20%
D) 50-60%
E) 60-100%
OBG-5.410.
What kind of congenital malformation should be expected after rubella
infections occurring on week 5 of gestation?
A) cardiac malformations
B) malformations of the inner ear
C) cataract, micropthtalmus
D) intracerebral calcification
E) dysplasia of long bones
OBG-5.411.
What kind of congenital malformation should be expected after rubella
infections occurring on week 6 of gestation?
A) cardiac malformations
B) malformations of the inner ear
C) cataract, micropthtalmus
D) intracerebral calcification
E) dysplasia of long bones
OBG-5.412.
What kind of congenital malformation should be expected after rubella
infections occurring between weeks 8 and 10 of gestation?
A) cardiac malformations
B) malformations -of the inner ear
C) cataract, micropthtalmus'
D) intracerebral calcification
E) dysplasia of long bones
OBG-5.413.
Radiographic signs of congenital syphilis include:
A) epiphyseal closure
B) the long bones are shorter than normal
C) the epiphyseal plates are irregular due to chondroepipihysitis
D) angulated spine
E) gaping fontanelles
OBG-5.414.
What is the mortality rate of fetal listeriosis?
A) 0.1-1.0%
B) 1.0-5.0%
C) 20-30%
D) 60-80%
E) 100
OBG-5.415.
What is the prevalence of congenital malformations in neonates born
to diabetic mothers?
A) 1%
B) 2%
C) 10%
D) 30%
E) 60%
OBG-5.416.
In Rh-isoimmunization, exhange transfusion is indicated if the serum
bilirubin level is higher in the first 24 hours than:
A) 10 mmol/1
B) 20 mmol/1
C) 50 mmol/1
D) 137 mmol/1
E) 250 mmol/1
OBG-5.417.
What blood type is needed to perform exchange transfusion for Rhincompatibility?
A) "0" Rh-negative
B) group matched blood
C) ABO group matched, Rh negative-blood
D) ABO group matched, Rh positive-blood
E) "0" Rh-positive
OBG-5.418.
What is the time limit for effective anti-D IgG administration to Rhnegative
women after delivery?
A) 1 day
B) 2 days
C) 3 days
D) 4 days
E) 5 days
OBG-5.419.
In which of the following seasons is the incidence of neonatal
hemorrhagic diatheses increased?
A) in summer
B) in autumn
C) in winter
D) in spring
E) there are no seasonal fluctuations in the incidence of neonatal
hemorrhagic diatheses
OBG-5.420.
Which of the following factors induces the differentiation of the gonads?
A) testosterone
B) estrogens
C) androgens produced by the adrenal cortex
D) sex chromosomes
E) pituitary hormones
OBG-5.421.
Which of the following factors induces the deveopment of the genital
tract and external genitalia in male fetuses?
A) testosterone
B) the combined effect of estrogen and testosterone
C) sex chromosomes
D) pituitary hormones
E) neither hormonal nor chromosomal effects are needed as male
sexual differentation is always the default
OBG-5.422.
Which of the following factors induces the deveopment of the genital
tract and external genitalia in female fetuses?
A) testosterone
BY the combined effect of estrogen and testosterone
C) sex chromosomes
D) pituitary hormones
E) neither hormonal nor chromosomal effects are needed as female
sexual differentation is always the default
OBG-5.423.
Which of the following features of gender develop during intrauterine
life in humans?
A) chromosomal and gonadal gender
B) gonadal and genital gender
C) chromosomal, gonadal and genital gender
D) chromosomal, gonadal, genital and somatic gender
E) gonadal, genital and somatic gender
OBG-5.424.
Which of the following features of gender develop during extrauterine
life in humans?
A) genital and somatic gender
B) gonadal, genital and somatic gender
OBG-5.428.
Which of the following are characteristic of the hormonal status of
patients with true hermaphroditism?
A) high gonadotropin levels; low estrogen and testosterone levels
B) low gonadotropin and estrogen levels
C) low gonadotropin and testosterone levels
D) low estrogen, testosterone and gonadotropin levels
E) the hormonal status is uncharacteristic
OBG-5.429.
Which of the following diganostic methods is the most appropriate
for the diagnosis of true hermaphroditism?
A) cytogenetic screening
B) inspection of the external genitalia
C) hormonal studies
D) laparoscopic examination of the internal genitalia
E) gonadal histology
OBG-5.430.
The karyotype characteristic of Klinefelter's syndrome is:
A) 46, XX
B) 46, XY
C) 45, XO
D) 47, XXY
E) 47, XYY
OBG-5.431.
Which of the following gonads can be found in a patient with
Klinefelter's syndrome?
A) the ovaries
B) the testes
C) ovotestis
D) a testis on one side and an ovary on the other ("streak" gonad)
OBG-5.432.
The karyotype characteristic of testicular feminisation is:
A) 46, XX
B) 46, XY
C) 45, XO
D) 47, XXY
E) 47, XYY
OBG-5.433.
Which of the following gonads can be found in a patient with
Klinefelter's syndrome?
A) the ovaries
B) the testes
C) ovotestis
D) a testis on one side and an ovary on the other ("streak" gonad)
OBG-5.434.
Which of the following disorders is likely if the female phenotype of
the patient is associated with a male (46, XY) genotype?
A) gonadal dysgenesis
B) Klinefelter's syndrome
C) testicular feminization
D) adrenogenital syndrome
E) male pseudohermaphroditism
OBG-5.435.
What is the phenotype of a patient with testicular feminization?
A) male
B) female
C) mixed
OBG-5.436.
The karyotype charecteristic of adrenogenital syndrome is:
A) 46, XX
B) 46, XY
C) 45, XO
D) 47, XXY
E) 47, XYY
OBG-5.437.
Which of the following conditions is characetized by a karyotype of
46, XX?
A) Turner's syndrome
B) testicular feminization
C) adrenogenital syndrome
D) female pseudohermaphroditism
E) Klinefelter's syndrome
OBG-5.438.
Which of the following conditions is characterized by a karyotype of
46, XY?
A) Turner's syndrome
B) Klinefelter's syndrome
C) adrenogenital syndrome
D) testicular feminization
E) female pseudohermaphroditism
OBG-5.439.
Which of the following are characteristic of the hormonal status of
patients with adrenogenital syndrome?
A) high 17-ketosteroid levels
B) high 17-ketosteroid and pregnantriol levels
C) high ACTH, 17-ketosteroid and pregnantriol levels
D) low estrogen and gonadotropin levels
E) high ACTH, 17-ketosteroid and pregnantriol levels, low
estrogen and gonadotropin levels
OBG-5.440.
Which of the following gonads can be found in a patient with
adrenogenital syndrome?
A) the ovaries
B) the testes
C) ovotestis
D) a testis on one side and an ovary on the other ("streak" gonad)
OBG-5.441.
Which of the following drugs would choose for the therapy of a patient
with adrenogenital syndrome?
A) estrogens
B) gonadotropins
C) cotricosteroids
D) ACTH
E) clomiphene citrate
OBG-5.442.
Which of the following preparations has a role in the etiology of the
so-called iatrogenic female pseudohermaphroditism?
A) stilbenes
B) androgen hormones
C) norsteroids
D) all of the above
E) only answers (B) and (C) are true
OBG-5.443.
Which of the following methods is appropriate for the prenatal detection
of adrenogenital syndrome?
A) the measurement of testosterone levels in maternal blood
B) the determination of maternal urinary 17-ketosteroid excretion
C) the measurement of testosterone 17-ketosteroid levels in the
amniotic fluid
D) the measurement of pregnandiol levels in the amniotic fluid
E) ultrasonography (reveals an enlarged clitoris and adrenal
hyperplasia)
OBG-5.444.
The karyotype characteristic of Turners syndrome is:
A) 46, XX
B) 46, XY
C) 45, XO
D) 47, XXY
E) 47, XYY
OBG-5.445.
Which of the following gonads can be found in a patient with Turner's
syndrome?
A) the ovaries
B) the testes
C) ovotestis
D) "streak" gonad
OBG-5.446.
Which of the following tests has the greatest importance in the diagnosis
of Turner's syndrome?
A) the assessment of the appearance of the patient (phenotype)
B) karyotyping
C) measurement of estrogen and gonadotropin levels
D) macro- and microscopic examination of the gonads
E) measurement of corticosteroid levels
OBG-5.447.
The karyotype characteristic of pure gonadal dysgenesis is:
A) 46, XX
B) 46, XY
C) 45, XO
D) 47, XXY
E) 47, XYY
OBG-5.448.
Which of the following statements characterize the function of the
hypothalamo-pituitary-ovarian system correctly in true precocious puberty?
A) menstruation is regular but ovulation is absent
B) regular ovulatory cycles similar to those in reproductive age
C) menstruation is usually absent, the appearance of sexual
changes depends on hormonal effects
D) menstruation is irregular with prolonged episodes
OBG-5.449. Which of the following characterizes hypotahalamo-pituitary-ovarian
function in precocious puberty?
A) regular function just as in women of reproductive age
B) amenorrhea is peresent in most cases, sexual maturation is
the result of steroid hormones
C) high gonadotropin and low estrogen levels
D) high estrogen and low gonadotropin levels
abdominal cramps
OBG-5.456.
Which of the following therapeutic methods should be applied for
controlling bleeding in juvenile metropathia?
A) curettage
B) hysteroscopy
C) hormonal (chemical) abrasion
D) suction curettage
E) no therapy is necessary, as this condition is transitory and selflimiting
OBG-5.457.
Which of the following drugs is inappropriate for (chemical) hormonal
abrasion?
A) ethinylestradiol (Mikrofollin)
B) norethisteron (Norcolut)
C) lynestrenol (Orgametril)
D) methylestrenolon (Orgasteron)
E) progesterone (Glanducorpin)
OBG-5.458.
Pubertal dysmenorrhea is caused by:
A) the vigorous contractions of the uterine musculature and
blood vessels
B) uterine hypoplasia and a narrow cervical canal
C) emotional factors, increased sensitivity to pain
D) all of the above
E) only answers (A) and (B) are true
OBG-5.459.
Which of the following may cause vaginal discharge of non-infectious
origin in puberty?
A) estrogen deficiency
B) psychogenic factors
C) sideropenia
D) all of the above
E) only answers (A) and (B) are true
OBG-5.460.
Why does adnexitis develop only rarely in gonorrheal vulvovaginitis
contracted in puberty?
A) the alkaline pH of the vagina (a consequence of low estrogen effect
on the vaginal epithelium) does not facilitate bacterial growth
B) immature endocervical glands are unsuitable for bacterial
colonization
C) symbiosis with Dbderlein's bacteria is a prerequisite to the
growth of gonococci and due to the absence of estrogen effect,
these bacteria are missing from the vaginal flora at this age
D) the course of the infection is the same in all age groups
OBG-5.461.
Why does Trichomonas vulvovaginitis develop only rarely before pubes
A) there is no occasion for infection to occur
B) the vaginal environment influenced by the effects estrogen is
unfavourable for bacterial growth
C)' the vaginal environment influenced by the lack of estrogen effects
OBG-5.465.
Which of the following is characteristic of the hormonal status in
amenorrhea of ovarian origin?
A) low gonadotropin and estrogen levels
B) high gonadotropin and estrogen levels
C) high gonadotropin and low estrogen levels
D) low gonadotropin and high estrogen levels
OBG-5.466.
Which of the following is characteristic of the hormonal status in
amenorrhea associated with hypopituitarism?
A) low gonadotropin and estrogen levels
B) high gonadotropin and estrogen levels
C) high gonadotropin and low estrogen levels
D) low gonadotropin and high estrogen levels
OBG-5.467.
What is the percentage of conditions of gonadal origin in primary
amenorrhea?
A) 0.1-.%
B) 2-3%
C) 30-40%
D) 80-90%
OBG-5.468.
The term "cryptomenorrhea" means:
A) an absence of menstruation for a period longer than 6 months
B) an absence of menstruation for a period longer than 3 months
C) the absence of menarche in a woman over 18 years of age
D) that blood and cellular debris can not be discharged due to
obstruction caused by the atretic hymen
E) despite the presence of all relevant symptoms, menstruation is
absent due to the destruction of the endometrium
OBG-5.469.
High gonadotropin levels suggest the dysfunction of the:
A) hypothalamus
B) pituitary gland
C) ovary
D) endometrium
E) high gonadotropin levels should beconsidered normal
OBG-5.470.
Permanently low gonadotropin levels suggest the dysfunction of the:
A) hypothalamus
B) pituitary gland
C) hypothalamic-pituitary system
D) ovary
E) uterus
OBG-5.471.
Low gonadotropin levels and normal hormone secretion by the ovaries
on administration of gonadotropins suggest the dysfunction of the:
A) hypothalamus
B) pituitary gland
C) hypothalamic-pituitary system
D) ovary
E) uterus
OBG-5.472.
Which of the following.drugs should be administered for
hypothalamic-pituitary insufficiency?
A) clomiphene citrate
B) serum and chorionoc gonadotropin
C) human menopausal gonadotropin
D) all of the above
E) none of the above
OBG-5.473.
What is the likely cause of vaginal bleeding if the estrogen and
estrogen-progesteron challenge tests as well as gonadotropin levels
are normal and the absence of pregnancy is certain?
A) hypothalamic dysfunction
B) pituitary dysfunction
C) ovarian dysfunction
D) uterine dysfunction
E) dysregulatory dysfunction
OBG-5.474. The most common cause of secondary amenorrhea is:
A) hypothalamic dysfunction
B) ovarian dysfunction
C) uterine dysfunction
D) vaginal dysfunction
E) adrenal dysfunction
OBG-5.475.
An eosinophilic adenoma of the pituitary causes:
A) gigantism and acromegalia
B) Cushing's disease
C) hyperprolactinemia
D) Sheehan's syndrome
E) Cushing's syndrome
OBG-5.476.
A basophilic adenoma of the pituitary causes:
A) gigantism and acromegalia
B) Cushing's disease
C) hyperprolactinemia
D) Sheehan's syndrome
E) Cushing's syndrome
OBG-5.477.
A hyperprolactinoma of the pituitary causes:
A) gigantism and acromegalia
B) Cushing's disease
C) hyperprolactinemia
D) Sheehan's syndrome
E) Cushing's syndrome
OBG-5.478.
The Chiari-Frommel syndrome is a type of amenorrhea-galactorrhea
syndrome that:
A) develops after delivery
B) is a consequence of neoplastic disease
C) is independent from pregnancy
D) is caused by extragenital factors
E) is caused by hyperthyroidism
OBG-5.479.
The Argonz-del Castillo syndrome is a type of amenorrheagalactorrhea
syndrome that:
A) develops after delivery
B) is a consequence of neoplastic disease
C) is independent from pregnancy
D) is caused by extragenital factors
E) is caused by hyperthyroidism
OBG-5.480.
The Forbes-Abright syndrome is a type of amenorrhea-.galactorrhea
syndrome that:
A) develops after delivery
B) is a consequence of neoplastic disease
C) is independent from pregnancy
OBG-5.484.
Which of the following is the most appropriate ovarian function testing
in patients with low gonadotropin and estrogen levels?
A) estrogen challenge test
B) progesteron challenge test
C) gonadotropin challenge test
D) LH-RH challenge test
E) clomiphene challenge test
OBG-5.485.
Which of the following is characteristic for the hormonal status in
the Stein-Leventhal syndrome?
A) high gonadotropin and low estrogen levels
B) normal gonadotropin and high estrogen levels
C) low gonadotropin and estrogen levels
D) normal gonadotropin and estrogen levels associated with high
testosterone levels
E) there is no characteristic hormonal abnormality
OBG-5.486.
Which of the following drugs is appropriate for the treatment of the
Stein-Leventhal syndrome?
A) clomiphene citrate
B) corticosteroids
C) bromocriptine
D) all of the above
E) only answers (A) and (B) are true
OBG-5.487.
Which of the following gynecologic endocrinopathies is treated by
the wedge resection of the ovaries?
A) anovulatory cycles
B) Stein-Leventhal syndrome
C) gonadotropin resistant ovary
D) ovarian hypoplasia
E) ovarian endometriosis
OBG-5.488.
Case Study:
A woman with oligomenorrhea has regular menses, deferes contraception,
does not want to be pregnant and has a prolonged follicular phase with
biphasic cycles. Which of the following is the appropriate therapy for this
condition?
A) ovulation induction
B) menstruation precipitation by the administration of estrogen
and progesterone
C) ovulation induction by estrogen administration
D) postponement of ovulation by estrogen administration
E) no therapy is necessary
OBG-5.489.
Case Study:
A women with oligomenorrhea has regular menses, deferes contraception,
does not want to be pregnant and has a prolonged luteal phase.
Which of the following is the appropriate therapy for this condition?
A) ovulation induction
B) menstruation precipitation by the administration of estrogen
and progesterone
C) ovulation induction by estrogen administration
D) postponement of ovulation by estrogen administration
E) no therapy is necessary
OBG-5.490.
Case Study:
A woman with oligomenorrhea has regular menses with anovulatory
cycles and fails to conceive? Which of the following is the appropriate
therapy for this condition?
A) ovulation induction
B) menstruation precipitation by the administration of estrogen
and progesterone
C) ovulation induction by estrogen administration
D) postponement of ovulation by estrogen administration
E) no therapy is necessary
OBG-5.491.
Case Study:
In a patient, polymenorrhea resuts in frequent bleeding and the development
of anemia. The patient does not want to be pregnant.
Which of the following is the appropriate therapy for this condition?
A) ovulation induction
OBG-5.494.
In secondary dysmenorrhea:
A) abdominal cramping is the leading symptom, seldom associated
with nausea and vomiting, etc.
B) nausea and malaise are the primary symptoms, not abdominal cramps
C) the symptoms develop after the first delivery
D) cramps and other symptoms are present from the time of the menarche
E) initially, menstruation is normal becomes associated with
cramps and other symptoms subsequently
OBG-5.495.
Which of the following describes the characteristic features of
hirsutism correctly?
A) body hair is more prominent but in the areas normally hairy in
females
B) masculine growth of body hair is observed all over the body
C) excessive growth of body hair is characteristic in areas normally
covered by lanuginose hair only
D) excessive, masculine growth of body hair is associated with
deepening of the voice and defeminization
E) excessive growth of body hair due to neoplastic disease and
associated with the enlargement of the clitoris
OBG-5.496.
Which of the following describes the characteristic features of
hypertrichosis correctly?
A) body hair is more prominent but in the areas normally hairy in
females
B) masculine growth of body hair is observed all over the body
C) excessive growth of body hair is characteristic in areas normally
covered by lanuginose hair only
D) excessive, masculine growth of body hair is associated with
deepening of the voice and defeminization
E) excessive growth of body hair due to neoplastic disease and
associated with the enlargement of the clitoris
OBG-5.497.
Which of the following describes the characteristic features of
virilism (masculinization) correctly?
A) body hair is more prominent but in the areas normally hairy in
females
B) masculine growth of body hair is observed all over the body
C) excessive growth of body hair is characteristic in areas normally
covered by lanuginose hair only
D) excessive, masculine growth of body hair is associated with
deepening of the voice and defeminization
E) excessive growth of body hair due to neoplastic disease and
associated with the enlargement of the clitoris
OBG-5.498.
Which of the following describes the characteristic features of sterility
correctly?
A) the failure to conceive after 2 years of unprotected intercourse
B) pregnancy develops but terminates before normal delivery
C) intercourse is not associated with sexual pleasure and does
not elicit orgasm
D) intercourse is impossible due to anatomical abnormalities of
the vagina
E) the failure to conceive after a year of unprotected intercourse
OBG-5.499.
Which of the following describes the characteristic features of infertility
correctly?
A) the failure to conceive after 2 years of unprotected intercourse
B) pregnancy develops but terminates before normal delivery
C) intercourse is not associated with sexual pleasure and does
not elicit orgasm
D) intercourse is impossible due to anatomical abnormalities of the
vagina
E) the failure to conceive after a year of unprotected intercourse
OBG-5.500.
The incidence of sterility is:
A) 1-2%
B) 3-4%
C) 8-10%
D) 20-25%
E) 25-30%
OBG-5.501.
The incidence of infertility is:
A) 1-2%
B) 3-4%
C) 5-6%
D) 20-25%
E) 30-40%
OBG-5.502.
What is the percentage of infertile marriages due to female factors?
A) 3-5%
B) 5-10%
C) 15-20%
D) 40-50%
E) 80-90%
OBG-5.503.
What is the percentage of infertile marriages due to male factors?
A) 3-5%
B) 5-10%
C) 10-15%
D) 35-40%
E) 80-90%
OBG-5.504.
What is the percentage of infertile marriages where no reproductive
abnormality can be detected?
A) 1-2%
B) 10-20%
C) 40-50%
D) 50-60%
E) 60-80%
OBG-5.505.
Which of the following conditions causes permanent infertility?
A) testicular feminization
B) Turner's syndrome
C) uterine aplasia
D) chronic aspecific perisalpingoophoritis
E) pure gonad dysgenesis
OBG-5.506.
What is the percentage of female sterility due to tubal obliteration?
A) 1-2%
B) 2-5%
C) 30-40%
D) 70-80%
E) 80-90%
OBG-5.507.
In which phase of the menstrual cycle should hysterosalpingography
be performed?
A) in the early follicular phase
B) at the time of ovulation
C) in the early secretory phase
D) in the late secretaory phase
OBG-5.508.
OBG-5.523.
How much is the Pearl-index of intrauterine devices?
A) 0.2-1.5
B) 2.0-8.0
C) 0.8-18.0
D) 2.4-28.0
E) 15.0-50.0
OBG-5.524.
How much is the Pearl-index of the condom?
A) 0.2-1.5
B) 2.0-8.0
C) 0.8-8.0
D) 6.0-28.0
E) 15.0-50.0
OBG-5.525.
How much is the Pearl-index of vaginal diaphragms (pessaries)?
A) 0.2-1.5
B) 2.0-8.0
C) 0.8-8.0
D) 6.0-28.0
E) 6.0-32.0
OBG-5.526.
OBG-5.533.
Which of the following is a minipill contraceptive containing progesterone
only?
A) Tri-Regol
B) Marvelon
C) Ovidon
D) Rigevidon
E) Continum
OBG-5.534.
How does the menses change under the effect of combined oral contraceptives?
A) it becomes more copious
B) it becomes reduced in volume
C) it remains unchanged
D) it becomes reduced in volume, and the intensity of cramping is
also reduced
E) the discharge of menstrual secretions becomes prolonged
OBG-5.535.
What should be done if breakthrough bleeding occurs dining the
use of oral contraceptives?
A) nothing, as this condition resolves spontaneously
B) the patient should suspend the use of contraceptives for 7
days then restart taking the tablets
C) the number of tablets taken should be increased; perhaps the
actual regimen should be supplemented by an estrogen preparation
D) switch to another contraceptive preparation
E) oral contraceptives should be stopped and an IUD should be
Inserted
OBG-5.536.
The most appropriate protocol for oral contraceptive use is:
A) to always start from the first day of menstruation and continue
taking the tablets for the next 21 days
B) 21 days on the pill followed by a 7-day pause
C) the tablets should be taken continuously, without interruption
D) depending on the length of the menstrual cycle, 18-35 days on
the pill followed by a 7-day pause
E) the tablets should be taken according to the calendar, from the
first day of the month to the 21 st day
OBG-5.537.
The most appropriate protocol for the minipill is:
A) to start always from the first day of menstruation and continue
taking the tablets for the next 21 days
B) 21 days on tablets followed by a 7-day pause
C) the tablets should be taken continuously, without interruption
D) the tablets should be taken according to the calendar, from the
first day of the month to the 21 st day
OBG-5.538.
The contraindications to oral contraceptive use include:
A) thromboembolism
B) liver disease
C) endocrine disorders
OBG-5.552.
Less traumatic methods for cervical dilation include:
A) the insertion of Laminaria into the cervical canal
B) the injection of Rivanol solution into the uterine cavity
C) the intracervical administration of prostaglandins
D) all of the above
E) only answers (B) and (C) are true
OBG-5.553.
The onset of menopause is usually expected between:
A) 42-45 years-old
B) 44-46 years-old
C) 46-48 years-old
D) 48-52 years-old
E) 52-55 years-old
OBG-5.554.
The onset of menopause is premature before the age of:
A) 40 years-old
B) 43 years-old
C) 50 years-old
D) 52 years-old
E) 55 years-old
OBG-5.555.
The menopause is delayed if uterine bleeding due to the cyclic
changes of ovarian hormones occurs before the age of:
A) 45 years-old
B) 48 years-old
C) 50 years-old
D) 52 years-old
E) 55 years-old
OBG-5.556.
Characteristic phenomena in premenopausal women include:
A) metrorrhagia
B) anovulatory cycles
C) reduction and cessation of fertility
D) all of the above
E) atrophy of the genitals
OBG-5.557.
Characteristic phenomena in postmenopausal women include:
A) neurovegetative symptoms referred to as the climacteric syndrome
B) atrophic changes of the genitals
C) pscychic disorders
D) all of the above
E) anovulatory cycles
OBG-5.558.
Case Study:
A 45-year-old female presents with metrorrhagia. The proper therapy
of this condition includes:
A) no intervention is necessary as failing ovarian function normally
results in metrorrhagia at this age
B) estradiol (Akrofollin)
C) estriol (Ovestin)
D) dienestrol (Dienoestrol)
OBG-5.565.
Case Study:
A 25-year-old woman with premature menopause would like to have
a child. Which of the following would you recommend?
A) pregnancy would be feasible by in vitro fertilization
B) therapy with clomiphene citrate as this is successful in most cases
C) Pergonal (FSH+LH) therapy is the only chance
D) there is no remedy for this condition as it represents irreversible infertility
E) laparotomy and wedge resection of the ovaries
OBG-5.566.
Which of the following extragenital disorders should be considered
in recurrent vulvitis?
A) intestinal helminthiasis
B) diabetes mellitus
C) pernicious anemia
D) Hodgkin's disease
E) all of the above
F) only answers (A) and (B) are true
OBG-5.567.
Which of the following tests should be performed to identify the
etiology of vulvitis?
A) a search for eggs
B) the staining and microscopic study of vulvar discharge
C) a measurement of blood glucose level and a peripheral blood count
D) all of the above
E) only answers (A) and (B) are true
OBG-5.568.
Which of the following diseases may cause vulvar pruritic vulvitis?
A) pernicious anemia
B) leukemia
C) Hodgkin's disease
D) all of the above
E) pancreatitis
OBG-5.569.
In which period of the day does intestinal hehninthiasis cause pnuitus?
A) in the morning
B) in the afternoon
C) in the evening
D) at night
OBG-5.570.
Which of the following extragenital diseases should be considered in
stubborn vulvar folliculitis?
A) inflammatory renal disease
B) chronic cystitis
C) diabetes mellitus
D) urethritis
E) intestinal helminthiasis
OBG-5.571.
Which of the following infections is associated with vaginal discharge
and itching?
A) gonococcal infection
B) Trichomonas vaginalis infection
C) fungal infections
D) bacterial infections
E) viral infections
OBG-5.572.
Which of the following is the pathogen of condylomata acuminata
(moist warts)?
A) bacteria
B) viruses
C) fungi
D) Trichomonas vaginalis
E) Treponema pallidum
OBG-5.573.
Which of the following is the appropriate treatment for condylomata
acuminata?
A) electrocautery
B) surgical extirpation
C) topical application of 20% podophyllin
D) topical application of (Vagothyl) polymethylen meta-cresolsulphonic
acid
E) all of the above
OBG-5.574.
Discharge due to hormonal effects occurs most freqently in/during:
A) neonatal age
B) puberty, the postmenopausal period and in elderly women
C) the puerperium
D) puberty
E) the use of oral contraceptives
OBG-5.575.
Characteristic macroscopic features of vaginal discharge in
Trichomonas vaginalis infection include:
A) thin and milky discharge
B) frothy, greenish and purulent discharge
C) the vaginal wall is covered by easily removable, whitefish-grey
material
D) thin, whitefish-grey discharge from the cervix
E) there are no characteristic macroscopic features
OBG-5.576.
Characteristic macroscopic features of vaginal discharge in fungal
infections include:
A) thin and milky discharge
B) frothy, greenish and purulent discharge
C) the vaginal wall is covered by easily removable, whitefish-grey
material
D) thin, whitefish-grey discharge from the cervix
E) there are no characteristic macroscopic features
OBG-5.577.
Which of the following drugs is used for the treatment of vaginal
trichomoniasis?
A) metronidazol (Klion) tablets and vaginal suppositories
B) natamycine (Pimafucin) vaginal tablets
C) clotrimazole (Canesten) tablets
D) all of the above
E) only answers (A) and (B) are true
OBG-5.578.
Which of the following lesions is considered a precancerous stage of
chorionic carcinoma?
A) cystic adenomatous hyperplasia of the endometrium
B) leukoplakia of the portio vaginalis of the cervix
C) hydatidiform mole
D) chronic cervicitis
E) placenta residues
OBG-5.579.
Which of the following hormones is secreted by chorionic carcinomas?
A) estrogen
B) progesterone
C) androgens
D) human chorionic gonadotropin
E) follicle stimulating hormone
OBG-5.580.
Which of the following gynecological malignancies are associated
with the positivity of pregnancy tests?
A) endometrial carcinoma
B) cervical carcinoma
C) chorionic carcinoma
D) hormonally active ovarian tumors
E) ovarian cystadenocarcinomas
OBG-5.581.
Which of the following obstetrical events are associated with the
subsequent development of chorionic carcinoma most frequently?
A) delivery
B) abortion
C) hydatidiform mole
D) ectopic pregnancy
E) missed abortion
OBG-5.582.
Which of the following cyst types can develop in chorionic carcinoma?
A) follicular cysts
B) hemorrhagic corpus luteum cysts
C) lutein cysts
D) endometriotic (chocolate) cysts
E) polycystic degeneration
OBG-5.583.
Which of the following tests is the most reliable for diagnosing
chorionic carcinoma at the earliest possible time?
A) Rana reaction
B) Gravimun test
C) Menotest
D) detection of hCG b-subunits by RIA
E) Ascheim-Zondek reaction
OBG-5.584.
Which of the following organs is involved in the metastatic spread of
chorionic carcinoma most fregently?
A) the vagina
B) the lung and brain
C) the liver and the kidneys
D) all of the above
E) the vagina, lung and brain only
OBG-5.585.
Suspected liver metastases of chorionic carcinoma are best detected by:
A) taking anteroposterior radiographs
B) tomography
C) scintigraphy
D) ultrasonography
E) the measurement of the hCG level
OBG-5.586.
Tumor regression induced by the cytotoxic chemotherapy of
chorionic carcinoma is best evaluated by:
A) the measurement of serum LH levels
B) the measurement of serum FSH levels
C) the measurement of serum hCG levels
D) all of the above
E) only answers (B) and (C) are true
OBG-5.587.
Cytotoxic chemotherapy gives the best results in the therapy of:
A) ovarian cystadenocarcinoma
B) endometrial adenocarcinoma
C) mesonephroid tumors
D) chorionic carcinoma
E) sarcoma
OBG-5.588.
Which of the following conditions is not associated with the development
of luteinized unruptuted ovarian follicles ("trapped oocytes")?
A) hydatidiform mole
B) chorionic carcinoma
C) FSH+LH therapy
D) therapy with clomiphene citrate
E) bromocriptine therapy
OBG-5.589.
Which of the following is a complication of benign ovarian tumors?
A) torsion of the pedicle of the cyst
B) infection, abscess formation
C) malignant transformation
D) all of the above
E) benign ovarian tumors cause no complications
OBG-5.590.
Pseudomyxoma peritonei is caused by the spillage of the contents of
a ruptured:
A) benign ovarian fibroepithelioma
B) mucinous glandular cyst
C) common serous cyst
D) papillary serous cyst
E) corpus luteum cyst
OBG-5.591.
Characteristic signs of Meigs' syndrome include:
A) pleural effusion
B) ascites
C) ovarian fibromyoma
D) all of the above
E) bilateral, smooth and firm mobile ovarian tumors
OBG-5.592.
Which of the following ovarian tumors cause Meigs' syndrome?
A) fibromyoma
B) dysgerminoma
C) cystic adenocarcinoma
D) granulosa cell tumor
E) sarcoma
OBG-5.593.
What is the percentage of primary tumors of all ovarian carcinomas?
A) 1-2%
B) 3-5%
C) 10-20%
D) 20-30%
E) 50-60%
OBG-5.594.
What is the percentage of secondary tumors of all ovarian carcinomas?
A) 1-2%
B) 3-5%
C) 30-40%
D) 60-70%
E) 80-90%
OBG-5.595.
What is the percentage of metastatic tumors of all ovarian carcinomas?
A) 10-20%
B) 30-40%
C) 40-50%
D) 60-70%
E) 70-90%
OBG-5.596.
Stage I ovarian carcinoma neoplastic disease involves:
A) one of the ovaries and fallopian tubes only
B) one or both ovaries
C) one or both ovaries and the pelvis
D) one or both ovaries and various intraabdominal organs
B) natural estrogens
C) progestogenic norsteroid compounds (19-nortestosterorone
derivatives)
D) natural progesterone derivatives
E) natural androgens
OBG-5.617.
Signs of excessive anteflexion of the uterus include:
A) dysmenorrhea
B) copious or minimal bleeding
C) sterility
D) habitual abortion
E) all of the above
F) only answers (A) and (B) are true
OBG-5.618.
In excessive anteflexion of the uterus, dysmenorrhea is caused by
the:
A) excessive contraction of the undeveloped uterine musculature
B) tight internal cervical orifice
C) compromise of uterine blood circulation
D) all of the above
E) only answers (A) and (B) are true
OBG-5.619.
The ratio between the length of the uterine corpus and the cervix is
normally:
A) 1:1
B) 2:1
C) 3:1
D) 1:2
E) 1:3
OBG-5.620.
In uterine hypoplasia, the ratio between the length of the uterine
corpus and the cervix is normally:
A) 1:1
B) 2:1
C) 3:1
D) 1:2
E) 1:3
OBG-5.621.
The ratio between the length of the uterine corpus and the cervix in
the infantile uterus is:
A) 1:1
B) 2:1
C) 3:1
D) 1:2
E) 1:3
OBG-5.622.
Excessive anteflexion of the uterus:
A) is expressed by the blunt angle of the uterine corpus and the
cervix
B) means that the angle of the uterine corpus and the cervix is
2) intravenous alcohol
3) barbiturates
4) ritodrine
OBG-5.655.
The prenatal treatment of congenital defects has been attempted in:
1) urinary bladder outlet obstruction
2) cardiac arrhythmias
3) adrenogenital syndrome
4) diaphragmatic hernia
OBG-5.656.
n patients with vulvar carcinoma, lymphatic drainage from regions
other than the clitoris is accumulated by the:
1) external iliac lymph nodes
2) superficial inguinal lymph nodes
3) deep fermoral inguinal lymph nodes
4) paraaortic lymph nodes
OBG-5.657.
In Potter's syndrome, a type of congenital malformations is comprised
of renal agenesis (and other renal abnormalities) and pulmonary
hypoplasia. Other associated anomalies include:
1) hydrocephalus
2) nodular amnion
3) cleft palate
4) of oligohydramnios
OBG-5.658.
Methods appropriate for the study of fetal chromosomes include:
1) amniocentesis
2) cordocentesis
3) chorionic villous sampling
4) echo-Doppler duplex flowmetry
OBG-5.659.
Which of the following substances have a demonstrated teratogenic
effect?
1) alcohol
2) isotretinoin (Accutane)
3) tetracyclines
4) progestogens
OBG-5.660.
Case Study:
A 24-year-old female victim of a car accident is admitted to the hospital.
A chest x-ray and lower spinal radiography is performed to assess
the extent of her injuries. Subsequently, it becomes known that
the patient is in the 10th week of pregnancy. The following information
should be given:
1) the fetus has received an irradiation of 50 rad
2) chorionic villous sampling or amniocentesis is indicated to
rule out fetal chromosomal abnormalities
3) in week 10 of the gestation, the fetus is extremely susceptible
to agents inducing the development of central nervous system
malformations
OBG-5.671.
Which of the following factors maintains normal development in female
puberty:
1) the sensitivity of the hypothalamus-pituitary axis to circulating
estrogen levels reduces
2) the development of a sleep-induced pulsatile GnRH pattern
3) the elevation of circulating estrogen levels
4) the serum levels of adrenocortical androgens decreases
OBG-5.672.
In the "Sertoli cell only" syndrome:
1) Leydig cell function is significantly reduced
2) no clinical symptoms are detected on examination
3) testosterone therapy effectively increases sperm concentration
4) FSH levels are elevated
OBG-5.673.
Which of the following belong to the effects of prostaglandins on the
reproductive system:
1) ovulation inhibition
2) luteolysis
3) the alleviation of dysmenorrhea
4) prostaglandins induce contractions of both the pregnant and
the non-pregnant uterus
OBG-5.674.
Estrogen dependent physiologic processes of the female organism
include:
1) menstruation
2) the cornification of the vaginal epithelium
3) the appearance of axillary hair
4) the production of cervical mucus
OBG-5.675.
Which of the following may cause delayed puberty?
1) anorexia nervosa
2) androgen excess syndromes
3) gonadal dysgenesis
4) chronic disease
OBG-5.676.
Which of the following statements are valid regarding the peripheral
transformation of androgens to estrogens in menopause?
1) the turnover of this process is determined by the fat content of
the body
2) this is responsible for the reduced prevalence of osteoporosis
in obese postmenopausal women
3f it may cause uterine bleeding, endometrlal hyperplasia or
adenocarcinoma
4) its incidence correlates with age
OBG-5.677.
Which problems of postmenopeusal women deserve special attention?
1) vaginitis
2) depression
3) osteoporosis
4) sexual dysfunction
OBG-5.678.
Significant factors of vaginal lubrication include:
1) the secretions of Skene's glands
2) mucus produced by endocervical glands
3) the viscous secretions of Bartholin's glands
4) a transudate-like fluid secreted by the vaginal wall
OBG-5.679.
Valid statements regarding menopause include:
1) it usually starts between the age of 40 to 50 years
2) is characterized by the absence of menstruation for 12 months
in women older than 45 years
3) menopause is always preceded by hot flushes
4) FSH and LH levels are elevated
OBG-5.681.
The pharmacological effects of oral contraceptives containing the
combination of estrogen and progesterone include:
1) the inhibition of the maturation of the oocyte
2) the prevention of the penetration of sperm into the cervical mucus
3) the inhibition of implantation by the induction of atrophic
changes of the endometrium
4) the induction of uterotubal hypermotility inhibits sperm motility
OBG-5.684.
Functional changes of the respiratory system during pregnancy include:
1) an increased respiratory volume
2) reduced residual volume
3) increased minute ventilation
4) an increased respiratory rate
OBG-5.685.
Valid statements regarding the changes of cardiac output during
pregnancy include:
1) during pregnancy, cardiac output is 30-50% higher than in
non-pregnant females
2) cardiac output is maximal in the second half of the pregnancy
(from week 20-24 to delivery)
3) initial increases of cardiac output are due to an increase of
ejection volume
4) in pregnancy, the changes of cardiac output are influenced
also by body posture
OBG-5.686.
Which of the following changes related to thyroxine may occur during
pregnancy?
1) the total serum thyroxine level increases
2) the free thyroxine level increase
3) the thyroxine binding globulin level
4) TSH levels decrease
OBG-5.687.
Which of the following laboratory parameters is expected to yield elevated
values during pregnancy?
OBG-5.703.
Which of the following is appropriate for the therapy of abnormal
uterine bleeding?
1) progesterone therapy
2) combined oral contraceptives
3) estrogen therapy
4) antiprostaglandin therapy
OBG-5.704.
Permanent estrogen replacement may be dangerous or explicitly
contraindicated in women with:
1) liver dysfunction
2) thromboembolic disorders
3) estrogen dependent neoplasms
4) have a mother or siblings with osteoporosis
OBG-5.705.
Valid statements regarding the psychic symptoms of climacterium
include:
1) insomnia, irritability, frustration and indisposition
2) the symptoms are often associated with estrogen therapy
3) the symptoms are influenced by hormonal, environmental and
intrapsychic factors
4) the symptoms are determined primarily by the educational
level of the patient
OBG-5.706.
Absolute contraindications to the use of oral contraceptives include:
1) thromboembolisc disorders
2) congenital hyperlipidemia
3) obesity and smoking for 35 years
4) ectopic pregnancy in the patient's history
OBG-5.707.
Contraindications to the insertion of an IUD include:
1) pelvic inflammatory disease in the patient's history
2) previous conception despite IUD use
3) abnormal genital bleeding
4) previous wedge resection of the cervix
OBG-5.708.
Artificial abortion performed in the second trimester by the injection
of hypertonic saline into the amniotic cavity:
1) is regulated by state legislation
2) may induce Rh-senzitization
3) may be followed by disseminated intravascular coagulation
(DIC)
4) may induce permanent hypertension
OBG-5.709.
The effects of the progestogenic component of oral contraceptives
include:
1) the inhibition of LH secretion
2) the induction of decidual transformation of the endometrium
3) the induction of the production of a more viscous cervical mucus
4) the prevention of metrorrhagia
OBG-5.710.
The effects of the estrogen component of oral contraceptives include:
1) the effect of the estrogen component always surpasses that of
the progestogerone component unless the dose of the latter is
increased significantly
2) the occurrence of thromboembolic events is directly related to
the dose of the estrogen component
3) the estrogen component suppresses LH secretion
4) the estrogen component suppresses FSH secretion
OBG-5.711.
Case Sudy:
A 36-year-old patient has 4 children. She visits her doctor for a
prescription for an oral contraceptive. She claims that she has been using contraceptives
without any problems for the last 15 years. The height of the
patient is 157 cm, body weight: 74 kg, blood pressure, 130/80 mmHg;
she smokes a pack of cigarettes a day. Which methods of the following
are the recommended contraceptive methods in this case?
1) continue the use of oral contraceptives
2) tubal ligation
3) the administration of medroxyprogesterone acetate (DepoProvera)
4) the insertion of an intrauterine device
OBG-5.712.
Valid statements regarding identical twins include:
1) identical twins often result after the use of intrauterine devices
2) identical twins often result after ovulation induction with
clomiphene citrate
3) the development of identical twins is more common than that
of fraternal twins
4) the incidence of this condition is 1:250 pregnancies
OBG-5.713.
Normally, which of the following has a serum concentration higher
in maternal blood than in fetal or cord blood?
1) immunoglobulin G (IgG)
2) immunoglobulin M (IgM)
3) hemoglobin y-chains
4) fibrinogen
OBG-5.714.
Ultrasonography performed in the third trimester detects:
1) anencephaly and major neural tube defects
2) fetal death
3) polyhydramnios
4) the accurate age of pregnancy
OBG-5.715.
Anticonvulsants with potential adverse effects resulting in the development
of congenital malformations include:
1) diphenylhydantoin
2) valproic acid
3) trimethadione
4) carbamazepine
OBG-5.716.
Risks associated with smoking during pregnancy and the puerperium
include:
1) the delivery of a low birth-weight neonate
2) spontaneous abortion
3) premature delivery
4) sudden infant death syndrome
OBG-5.717.
Severe fetal or neonatal disease may result from maternal infection
by which of the following viruses?
1) Coxsackie B virus
2) Rubellavirus
3) Smallpox virus
4) type 2 Herpesvirus hominis
OBG-5.718.
The fetal or neonatal consequences of maternal diabetes include:
1) macrosomia
2) delayed pulmonary maturation
3) hypoglycemia
4) hypocalcemia
OBG-5.719.
Valid statements regarding toxoplasmosis developing in pregnancy
include:
1) the infection is contracted by the consumption of raw meat
2) the infection is contracted by contact with feline feces
3) infection occurring in the early stage of pregnancy may result
in abortion
4) the incidence of this condition is 1:2,000-2,500 pregnancies
OBG-5.720.
Hormones produced by the human placenta include:
1) gonadotropin
2) somatomammotropin (hCS)
3) progesterone
4) hydrocortisone
OBG-5.721
The risk of fetal morbidity and mortality is maternal diabetes is increased
by:
1) maternal ketoacidosis
2) maternal ketonuria occurring without diabetic ketoacidosis
3) maternal hyperglycemia
4) maternal hypoglycemia
OBG-5.722.
An increased risk of postpartum bleeding should be expected after/
in:
1) prolonged delivery
2) rapid delivery
3) the stimulation of uterine contractions with oxytocin
4) multiple pregnancy
OBG-5.723.
Which of the following drugs are appropriate for the therapy of
postpartum bleeding?
1) ergometrine
2) oxytocin injection
3) ergotamine
4) prostaglandins
OBG-5.724.
Antibiotics contraindicated during pregnancy include:
1) tetracyclines
2) penicillin
3) chloramphenicol
4) ampicillin
OBG-5.725
Valid statements regarding ectopic pregnancy include:
1) the Arias-Stella reaction is of diagnostic significance in ectopic
pregnancy
2) ectopic pregnancies developing in the interstitium usually rupture
later, bleed heavier and are more difficult to diagnose than
isthmic or ampullary pregnancies
3) most ectopic pregnancies can be detected by ultrasonography
because this imaging method delineates the gestational sac
outside the uterine cavity
4) ectopic pregnancies develop most often in the tubal isthmus
OBG-5.726.
The indications for monocomponent chemotherapy following the
evacuation of a hydatidiform mole include:
1) elevated hCG titers
2) hCG titers fail to decrease in 3 consecutive weeks
3) hCG titers are not normalized by week 8 after evacuation
4) hCG titers decrease rapidly
OBG-5.729.
Experience with the use of actinomycin D and methotrexate in the
therapy of trophoblastic disease shows that:
1) resistance developing to one of these preparations results in
cross-resistance to the other
2) actinomycin D is safer than methotrexate in patients with liver
impairment
3) the effects of these substances are not additive in combination
4) applied initially, actinomycin D is as effective as
methotrexate
OBG-5.740.
The imperforate hymen may result in the development of:
1) hematocolpos
2) dysuria
3) hematometra
4) periodic lower abdominal pain
OBG-5.741.
Acute urinary retention may result from:
1) retroflexion of the pregnant uterus
2) uterine obstruction caused by a myoma
3) hematocolpos
4) pelvic hematocele
OBG-5.742.
Laparoscopy is CONTRAINDICATED:
1) during menstruation
2) in patients with descensus of the pelvic floor
3) in pelvic tuberculosis
4) in intestinal obstruction
OBG-5.743.
Multiple pregnancy carries an increased risk of:
1) toxemia occurring in the late phase of the pregnancy
2) higher perinatal fetal loss
3) premature delivery
4) acute excess of amnitic fluid
OBG-5.744.
In iron deficiency anemia associated with 9-1l g% hemoglobin levels:
1) stainable iron is missing from the bone marrow
2) serum iron levels are reduced
3) serum iron-binding capacity is elevated
4) microcytosis is present
OBG-5.745.
The fetal heart rate is influenced by:
1) the age of the pregnancy
2) vagal tone
3) uterine bleeding
4) magnesium sulphate
OBG-5.746.
In addition to the serum bilirubin concentration, drugs facilitating
the development of kernicterus include:
1) salicylates
2) sulfonamides
3) furosemide
4) gentamicin
OBG-5.747.
Glucose-6-phosphate deficiency:
1) is a congenital error of metabolism with an X-linked inheritance
pattern
2) is associated with an increased incidence of urinary tract infection
during pregnancy
3) may cause fetal hydrops
cause ;aundice in neonates
OBG-5.748.
Amniocentesis is indicated for the diagnosis of the following
autosomal disorders:
1) Hurler's syndrome
2) Tay-Sachs disease
3) Pompe disease
4) Lesch-Nyhan syndrome
OBG-5.749.
Factors predisposing a neonate to kernicterus include:
1) a low body temperature
2) infection
3) hypoglycemia
4) perinatal asphyxia
OBG-5.755.
Hormonal replacement is recommended in climacteric women:
1) for the prevention of atherosclerotic heart disease
2) for the alleviation of vasomotor symptoms
3) to reverse osteoporosis
4) for the treatment of the atrophy of the vaginal mucosa
OBG-5.760.
Characteristic features of Turner syndrome (45, XO) include:
1) a low stature
2) a female gender with bilateral inguinal hernia
3) hypergonadotropic amenorrhea with low estrogen levels
4) elevated gonadotropin levels, the presence of ovarian follicles
and amenorrhea
OBG-5.761.
Valid statements regarding the maturation of oocytes include:
1) available information suggests that the eleveation of estradiol
levels in the late follicular pahse induce the fluctuation of
gonadotropin levels
2) exogenous estrogen replacement does not influence the release
of gonadotrophic hormones
3) abnormal androgen levels may suppress the pulse generator
and GnRH release
4) follicles mature independently of pituitary prolactin secretion
OBG-5.762.
Asymtpomatic bacteriuria in women:
1) has a prevalence of 15-17% among all females
2) has been defined arbitrarily as the presence of 100,000 bacteria
per millilitre of urine
3) is caused by Streptococcus fecalis predominantly
4) causes pyelonephritis in 30% of cases
OBG-5.763.
Placental abruption may be associated with:
1) renal insufficiency
2) dyspnea
3) disseminated intravascular coagulation
4) heart failure
OBG-5.764.
Hemodynamic changes associated with the shifting from fetal to
neonatal circulation result in:
1) the constriction of umbilical vessels and the gradual obliteration
of the foramen ovale as well as the ductus venosus
2) the fall of systemic blood pressure
3) expansion of the fetal lung
4) reversal of the direction of blood flow in the ductus arteriosus
OBG-5.765.
In humans, the ovary can produce:
1) dehydrosoandrosterone
2) androstendione
3) testosterone
4) dehydroepiandrostendione
OBG-5.766.
Case Study:
A patient displays mild uterine irritability in the 35th week of her pregnancy
despite avoiding exertion as much as possible and her blood
pressure is also significantly elevated. Although prompt hospitalization
reversed these symptoms, intensive monitoring was institued.
Which of the following symptoms is/are of concern in week 36?
1) urinary estriol levels are below the tenth of the normal value of
the hospital's laboratory
2) according to the results of serial ultrasonographies, the
growth-rate of the fetus is below 10%
3) amniocentesis yielded clear amniotic fluid (with an L/S ratio of
2.2 and a 2.0 mg% creatinine level)
4) the maternal serum prolactin level decreased below 4 mg/ml
ASSOCIATION QUESTIONS
Associate the following terms/statements marked by the letters A, B,
C... with the corresponding statements/terms marked by and in the
order given by the figures 1, 2, 3...
...for example: 1-C, 2-B, 3-A, 4-D. Put the answer as C, B, A, D!
(Note: Different statements can be associated with the same terms!!!)
OBG-5.767.
Associate the following term(s) with their corresponding statement(s)!
A) Genital tubercle
B) Genital bud
C) Urogenital sinus
D) Urethral folds
E) Mllerian ducts
1) labia minora
2) labia majora
3) clitoris
4) lower third of the vagina
5) oviducts
OBG-5.768.
Associate the following term(s) with their corresponding statement(s)!
A) Uterine vein
B) B) Right ovarian vein
C) Left ovarian vein
D) Uterine artery
E) Ovarian artery
1) hypogastric artery (emerges from the internal iliac artery)
2) joins the internal iliac veins
3) joins the inferior vena cava
4) emerges from the abdominal aorta
5) joins the left renal vein
OBG-5.769.
Associate the following term(s) with their corresponding statement(s)!
A) Spontaneous abortion
B) Threatened abortion
C) Habitual abortion
D) Therapeutic abortion
E) Elective abortion
1) termination of the pregnancy on maternal indication before the
fetus attains viability
2) termination of the pregnancy before the fetus attains viability
on indication other than the protection of maternal health or
from causes other than fetal disease
3) spontaneous termination of gravidity occurring in about 10%
of all pregnancies
4) spontaneous termination of gravidity associated with chromosomal
abnormalities in 50-60% of cases
5) spontaneous termination of gravidity that is unfeasible in the
case of the first pregnancy .
OBG-5.770.
Associate the following statement(s) with their corresponding term(s)!
A) oral contraceptive use should be suspended for 7 days then
reinstituted
B) oral contraceptives should be continued as ususal
C) oral contraceptives should be continued and a supplemental
contraceptive method should be applied in addition
D) an extra tablet should be taken
E) oral contraceptive use should be abandoned and a diagnostic
workup is necessary
1) Nausea occurring in the first cycle during oral contraceptive use
2) Menstruation is absent during the 7 days following the 21-day
long period of proper oral contraceptive use
3) The patient has forgotten to take one tablet
4) The patient has forgotten to take oral contraceptives for 10
consecutive days
5) Slight bleeding at midcycle during the first month of oral contraceptive
use
6) Hemoptysis
OBG-5.771.
Associate the following term(s) with their corresponding statement(s)!
A) Ectopic pregnancy
B) Cortisol excess
C) 21-Hydroxylase deficiency
D) 19-Nortestosterone-progestins
E) Toxic inflammatory endometritis
1) centripetal obesity, moon-face, purple striae
2) 10% incidence of ectopic tubal pregnancy
3) congenital adrenal hyperplasia
4) supresses luteinizing hormone-releasing factor secretion
5) Arias-Stella phenomenon
OBG-5.772.
Associate the following statement(s) with their corresponding term(s)!
A) 47 XXY
B) 45 XO
C) trisomy 21
D) Tay-Sachs disease
E) testicular feminization
1) Down's syndrome
2) Klinefelter syndrome
3) Turner's syndrome
4) The most prevalent XY female-syndrome
5) Amniocentesis
OBG-5.774.
Associate the following term(s) with their corresponding statement(s)!
A) Methylene blue
B) Gram-stain
C) Ziehl-Nielsen stain
D) Papanicolau stain
E) Hematoxylin-eosin stain
1) Gonococcus
2) Mycobacterium tuberculosis
3) mixed bacterial flora
4) oncocytology smear
5) hormonal cytology smear
OBG-5.775.
Associate the following term(s) with their corresponding statement(s)!
A) Bacillus crassus
B) Trichomonas vaginalis
C) Treponema pallidum
D) Rickettsiae
E) Haemophylus ducreyi
F) Chlamydia lymphogranulomatis
1) chancroid
2) lymphogranuloma inguinale
3) chlamydiasis
4) syphilis
5) acute vulvar ulcer
CASE STUDIES
Answer the multiple task questions (simple choice and multiple choice
with/without key answers; relation analysis etc.) as they are related to
each case study!!!
OBG-5.776.
Case Study
A 24-year-old primigravida presents in the 28th week of her pregnancy
with spider nevi, palmar erythema and diffuse pruritus.
Liver function test results: alkaline phosphatase: 190 IU/l (normal
value: 29-91 IU/1); SGOT: 38 IU/1 (normal value: 6-18 IU/1); total
bilirubin: 1.8 mg% (normal value: 0.3-1.0 mg%); direct bilirubin: 1.0
mg% (normal value 0.1-0.3 mg%).
5.776/ 1.
The most likely diagnosis is:
A) liver cirrhosis
B) infectious hepatitis
C) cholestasis
D) acute pancreatitis
E) cholecystitis
5.776/2.
After delivery, the doctor should recommend to the patient:
A) not to have any more babies
B) to abstain from food with a high fat content and not to take
oral contraceptives
C) to avoid exertion
D) to undergo a cholecystectomy
E) none of the above
OBG-5.777.
Case Study
A 20-year-old female presents at the clinic with lower abdominal pain.
Her menstruation cycle is regular and she has not been pregnant yet.
At present, she is taking an oral contraceptive.
Colposcopy: ectopic tissue on the portio vaginalis of the cervix.
Pelvic examination: average vaginal capacity, smooth, firm portio
vaginalis, regular, large uterine corpus in avf. The uterus is mobile,
palpation is normal on the right side. On the left side, ventrally, a
semisolid, clearly delineate mobile mass is palpated.
5.777/ 1.
The most likely diagnosis is:
A) ovarian endometriosis
B) malignant ovarian neoplasm
C) uterine myoma
D) dermoid cystoma
E) paraovarian cyst
5.777/2.
What can be seen on an anteroposterior radiograph of the pelvis?
A) calcification
B) phleboliths
C) psammoma bodies
D) a soft-tissue shadow
E) calcification within a soft-tissue shadow
5.777/3.
What is the percentage of neoplasms occurring in both ovaries simultaneously?
A) 1%
B) 15%
C) 25%
D) 40%
E) 60%
5.777/4.
Which of the following is a possible complication of this neoplasm?
A) torsion of the pedicle of the cyst
B) suppuration and peritonitis
C) malignant transformation
D) all of the above
E) only answers (A) and (C) are true
5.777/5.
What is the prognosis of this tumor?
A) good, as malignant transformation seldom occurs
B) extremely good, as malignant transformation does not occur
C) malignant transformation is common, thus it cannot be detected
at an early stage
D) poor, beacuse it is a malignant lesion
5.777/6.
The appropriate therapy is:
A) puncture and aspiration of the contents via the vaginal route
B) laparoscopic aspiration of the contents
C) laparotomy to remove the tumor selectively with the preservation
of functional ovarian remnants
D) laparotomy with oophorectomy in all cases
E) laparotomy with bilateral oophorectomy as bilateral occurrence
is common
OBG-5.789.
Case Study
A 55-year-old nulliparous, postmenopausal woman presents with
bloody vaginal discharge present for the last 7 days.
Status: The portio vaginalis of the cervix and the vaginal wall is covered
ered by atrophic epithelium that bleeds easily. The uterus is hypoplastic, smaller than normal,
no adjacent abnormality is palpated.
5.789/ 1.
The most likely cause of the bleeding is:
A) cervical polyp
B) senile vaginitis
C) cervical carcinoma
D) endometrial carcinoma
E) hormone secreting ovarian neoplasm
5.789/2.
What should be done next?
A) the bleeding should be controlled by estrogen administration
B) fractional curettage should be performed
C) oncocytology testing is recommended
D) chemical curettage is necessary
E) nothing should be done
5.789/3.
Curettage yields copious medullary tissue from the uterine cavity.
The most likely diagnosis is:
A) senile endometritis
B) submucous myoma
C) endometrial carcinoma
D ervical
5.789/4.
Which of the following conditions are associated with an increased'
risk of endometrial carcinoma?
A) obesity
B) hypertension
C) diabetes
D) functional sterility in the history (anovulation)
E) all of the above
5.789/5.
Which of the following methods should be applied as the first choice
therapy of endometrial carcinoma?
A) irradiation
B) surgery (hysterectomy)
C) norsteroid therapy
D) cytotoxic chemotherapy
E) the combination of (A), (B) and (C)
201.C
202.D
203.D
204.B
205.D
206.D
207.D
208.C
209.A
210.B
211.C
212.D
213.214.E
215.B
216.A
217.E
218.D
219.E
220.A
221.E
222.B
223.A
224.225.C
226.D
227.228.D
229.D
230.E
231.D
232.D
233.E
234.D
235.D
401.B
402.C
403.C
404.A
405.C
406.B
407.D
408.B
409.C
410.C
411.A
412.B
413.C
414.C
415.C
416.D
417.C
418.C
419.C
420.D
421.A
422.E
423.C
424.D
425.E
426.C
427.D
428.E
429.E
430.D
431.B
432.B
433.B
434.C
435.B
601.C
602.C
603.D
604.A
605.C
606.C
607.D
608.B
609.B
610.C
611.C
612.E
613.D
614.C
615.D
616.C
617.E
618.E
619.B
620.B
621.D
622.B
623.A
624.E
625.B
626.A
627.C
628.E
629.E
630.D
631.E
632.C
633.B
634.A
635.D
36.E
37.A
38.C
39.E
40.D
41.C
42.E
43.C
44.B
45.C
46.B
47.C
48.D
49.C
50.A
51.E
52.E
53.D
54.C
55.B
56.D
57.C
58.C
59.A
60.E
61.A
62.C
63.C
64.E
65.D
66.C
67.68.69.D
70.D
71.D
72.73.E
74.E
75.D
76.77.78.79.D
80.D
81.C
82.E
83.A
84.D
236.D
237.E
238.B
239.D
240.B
241.D
242.B
243.D
244.245.D
246.247.D
248.D
249.E
250.E
251.D
252.E
253.D
254.255.E
256.D
257.E
258.D
259.E
260.B
261.B
262.C
263.C
264.D
265.D
266.B
267.C
268.C
269.C
270.A
271.C
272.C
273.C
274.D
275.D
276.D
277.E
278.E
279.D
280.B
281.C
282.D
283.B
284.A
436.A
437.C
438.D
439.E
440.A
441.C
442.D
443.C
444.C
445.D
446.D
447.A
448.B
449.E
450.A
451.D
452.B
453.B
454.D
455.B
456.C
457.A
458.D
459.D
460.B
461.C
462.D
463.C
464.B
465.C
466.A
467.D
468.D
469.C
470.C
471.C
472.D
473.D
474.A
475.A
476.B
477.C
478.A
479.C
480.B
481.D
482.E
483.D
484.C
636.C
637.A
638.A
639.E
640.B
641.B
642.A
643.E
644.C
645.B
646.C
647.C
648.D
649.A
650.B
651.A
652.E
653.D
654.C
655.E
656.A
657.C
658.A
659.A
660.D
661.662.663.664.A
665.A
666.667.A
668.C
669.A
670.E
671.A
672.D
673.D
674.E
675.E
676.E
677.E
678.E
679.C
680.681.A
682.683.684.A
85.C
86.A
87.B
88.D
89.C
90.C
91.B
92.B
93.94.C
95.A
96.E
97.D
98.D
99.D
100.C
101.C
102.D
103.E
104.B
105.C
106.B
107.E
108.D
109.E
110.D
111.A
112.B
113.B
114.C
115.B
116.B
117.E
118.D
119.D
120.E
121.D
122.B
123.A
124.E
125.A
126.C
127.E
128.E
129.D
130.D
131.D
132.E
133.A
285.B
286.C
287.C
288.A
289.B
290.C
291.E
292.E
293.D
294.E
295.A
296.E
297.B
298.E
299.C
300.B
301.A
302.B
303.B
304.A
305.C
306.D
307.B
308.C
309.A
310.C
311.C
312.C
313.D
314.D
315.E
316.D
317.A
318.E
319.A
320.C
321.B
322.C
323.A
324.B
325.C
326.B
327.D
328.D
329.B
330.A
331.B
332.B
333.C
485.E
486.E
487.B
488.E
489.E
490.A
491.E
492.A
493.D
494.E
495.C
496.A
497.D
498.A
499.B
500.C
501.D
502.D
503.D
504.B
505.D
506.C
507.A
508.D
509.B
510.E
511.B
512.D
513.C
514.B
515.A
516.D
517.D
518.D
519.B
520.C
521.A
522.B
523.C
524.D
525.E
526.B
527.B
528.E
529.C
530.D
531.B
532.D
533.E
685.E
686.B
687.C
688.D
689.A
690.691.A
692.693.694.695.696.697.698.699.700.E
701.C
702.E
703.A
704.A
705.B
706.A
707.B
708.A
709.E
710.C
711.C
712 D
713.C
714.A
715.A
716.E
717.E
718.E
719.A
720.A
721.E
722.E
723.E
724.B
725.A
726.A
727.728.729.C
730.731.732.733.-
134.E
135.B
136.A
137.C
138.B
139.D
140.B
141.C
142.D
143.A
144.E
145.E
146.C
147.D
148.D
149.C
150.D
151.152.A
153.D
154.155.E
156.B
157.158.E
159.160.161.E
162.D
163.D
164.D
165.D
166.E
167.B
168.C
169.170.171.C
172.D
173.A
174.E
175.A
176.C
177.A
178.D
179.B
180.D
181.D
182.D
334.D
335.B
336.D
337.A
338.C
339.C
340.B
341.E
342.E
343.D
344.E
345.C
346.E
347.E
348.D
349.D
350.B
351.A
352.D
353.D
354.C
355.D
356.A
357.A
358.E
359.C
360.B
361.C
362.D
363.D
364.B
365.C
366.D
367.D
368.C
369.B
370.D
371.C
372.A
373.D
374.D
375.A
376.B
377.C
378.B
379.C
380.E
381.D
382.B
534.D
535.C
536.B
537.C
538.D
539.E
540.C
541.B
542.B
543.D
544.D
545.D
546.D
547.E
548.B
549.C
550.D
551.E
552.D
553.D
554.C
555.E
556.D
557.D
558.D
559.A
560.B
561.C
562.A
563.B
564.C
565.D
566.E
567.D
568.D
569.D
570.C
571.C
572.B
573.E
574.B
575.B
576.C
577.A
578.C
579.D
580.C
581.C
582.C
734.735.736.737.738.739.740.E
741.E
742.D
743.E
744.A
745.E
746.E
747.E
748.A
749.E
750.751.752.753.754.755.C
756.757.758.759.760.B
761.B
762.C
763.B
764.E
765.A
766.E
767.DBACE
768.DABEC
769.DEAAC
770.BBCCBE
771.BECDA
772.CABED
773.774.BCADA
775.EEFCA
776.CB
777.DEAEAC
778.779.780.781.782.-
183.E
184.E
185.B
186.E
187.A
188.D
189.C
190.E
191.192.E
193.B
194.D
195.196.C
197.D
198.D
199.E
200.B
383.C
384.D
385.D
386.C
387.C
388.C
389.D
390.E
391.D
392.C
393.B
394.A
395.A
396.B
397.B
398.C
399.D
400.D
583.D
584.D
585.C
586.C
587.D
588.E
589.D
590.B
591.D
592.A
593.E
594.C
595.A
596.B
597.C
598.C
599.D
600.D
783.784.785.786.787.788.789.DBCEB
790.791.792.-